Provider Demographics
NPI:1003863515
Name:BITTIKER, STEPHEN B (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:B
Last Name:BITTIKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7135 STATE ROAD 52
Mailing Address - Street 2:SUITE 304
Mailing Address - City:BAYONET POINT
Mailing Address - State:FL
Mailing Address - Zip Code:34667-6782
Mailing Address - Country:US
Mailing Address - Phone:727-868-8770
Mailing Address - Fax:727-869-0302
Practice Address - Street 1:7135 STATE ROAD 52
Practice Address - Street 2:SUITE 304
Practice Address - City:BAYONET POINT
Practice Address - State:FL
Practice Address - Zip Code:34667-6782
Practice Address - Country:US
Practice Address - Phone:727-868-8770
Practice Address - Fax:727-869-0302
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0002359111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT88424Medicare UPIN
FL88424Medicare ID - Type Unspecified