Provider Demographics
NPI:1033261482
Name:REDWOOD, ALIYA (DC)
Entity Type:Individual
Prefix:DR
First Name:ALIYA
Middle Name:
Last Name:REDWOOD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27210 FOAMFLOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-4036
Mailing Address - Country:US
Mailing Address - Phone:813-973-2261
Mailing Address - Fax:
Practice Address - Street 1:27210 FOAMFLOWER BLVD
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-4036
Practice Address - Country:US
Practice Address - Phone:813-973-2261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6743111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55156Medicare ID - Type Unspecified
FLU50948Medicare UPIN