Provider Demographics
NPI:1003339342
Name:SOTIRIOS PAPPAS, M.D., D.C., LLC
Entity Type:Organization
Organization Name:SOTIRIOS PAPPAS, M.D., D.C., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOTIRIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPPAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DC
Authorized Official - Phone:386-589-0089
Mailing Address - Street 1:5901 TOSCANA DR APT 1211
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-3570
Mailing Address - Country:US
Mailing Address - Phone:386-589-0089
Mailing Address - Fax:
Practice Address - Street 1:2415 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6605
Practice Address - Country:US
Practice Address - Phone:954-456-0250
Practice Address - Fax:954-456-0820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9491111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty