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NPI Code Detail

MEDICARE: DR. AMY ELIZABETH JABANOSKI D.C.

MEDICARE: DR. AMY ELIZABETH JABANOSKI 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
1111N00000XChiropractor38MC00648700NJ
2111N00000XChiropractorCH9709FL

General Provider Information

NPI Number : 1700804515
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMY ELIZABETH JABANOSKI D.C.
Provider Business Mailing Address
First Line : 3138 REGATTA CIR
Second Line :
City : SARASOTA
State : FL
Zip : 34231-8114
Country : US
Telephone Number : 908-868-3371
Fax Number : 941-725-7561
Provider Business Practice Location Address
First Line : 2423 BEE RIDGE RD
Second Line :
City : SARASOTA
State : FL
Zip : 34239-6304
Country : US
Telephone Number : 941-921-6656
Fax Number : 941-925-7561
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 02/09/2009

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