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NPI Code Detail

MEDICARE: DR. EVAN JARED MADOW D.C.

MEDICARE: DR. EVAN JARED MADOW D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCH0006389FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
144-88108OTHERFLUNITED HEALTHCARE
222693OTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1548319817
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EVAN JARED MADOW D.C.
Provider Business Mailing Address
First Line : 7500 BRYAN DAIRY RD STE B
Second Line :
City : LARGO
State : FL
Zip : 33777-1437
Country : US
Telephone Number : 727-548-8100
Fax Number : 727-548-8112
Provider Business Practice Location Address
First Line : 7500 BRYAN DAIRY RD STE B
Second Line :
City : LARGO
State : FL
Zip : 33777-1437
Country : US
Telephone Number : 727-548-8100
Fax Number : 727-548-8112
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 12/30/2025

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