Provider Demographics
NPI:1003151473
Name:MIDTOWN CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:MIDTOWN CHIROPRACTIC LLC
Other - Org Name:CORDERO FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-735-8833
Mailing Address - Street 1:3208 LANTANA RD
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-2432
Mailing Address - Country:US
Mailing Address - Phone:561-439-7349
Mailing Address - Fax:
Practice Address - Street 1:3208 LANTANA RD
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-2432
Practice Address - Country:US
Practice Address - Phone:561-439-7349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10028111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty