MEDICARE: NORTH TAMPA SPINE & JOINT CENTER 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	111NR0400X	Rehabilitation Chiropractor

General Provider Information

NPI Number	:	1851624456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH TAMPA SPINE & JOINT CENTER LLC

Provider Business Mailing Address
First Line	:	17429 BRIDGE HILL CT
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3467
Country	:	US
Telephone Number	:	813-983-7921
Fax Number	:	813-333-2788

Provider Business Practice Location Address
First Line	:	17429 BRIDGE HILL CT
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3467
Country	:	US
Telephone Number	:	813-983-7921
Fax Number	:	813-333-2788

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	DR. CONNOR J. OLIVERI
Credential	:	DC
Telephone Number	:	813-983-7921

Provider Enumeration Date	:	09/14/2009
Last Update Date	:	01/06/2026

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