MEDICARE: INNATA SPINAL CARE LLC

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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1821923947
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNATA SPINAL CARE LLC

Provider Business Mailing Address
First Line	:	10887 CALADESI AVE APT 302
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-9773
Country	:	US
Telephone Number	:	787-484-0601
Fax Number	:

Provider Business Practice Location Address
First Line	:	1211 TECH BLVD STE 134
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-7845
Country	:	US
Telephone Number	:	813-203-3262
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	CRISTAL ANELIS VARGAS SANTIAGO
Credential	:	DC
Telephone Number	:	787-484-0601

Provider Enumeration Date	:	06/17/2026
Last Update Date	:	06/17/2026

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