MEDICARE: NALDA FAMILY CHIROPRACTIC

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	CH 7445	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	55655	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1962618157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NALDA FAMILY CHIROPRACTIC

Provider Business Mailing Address
First Line	:	PO BOX 700116
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34770-0116
Country	:	US
Telephone Number	:	407-957-1337
Fax Number	:	407-957-1848

Provider Business Practice Location Address
First Line	:	4041 13TH ST
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34769-6772
Country	:	US
Telephone Number	:	407-957-1337
Fax Number	:	407-957-1848

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. ANTHONY G NALDA
Credential	:	DC
Telephone Number	:	407-957-1337

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	08/22/2020

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