Provider Demographics
NPI:1073609616
Name:DONALD J. KRIPPENDORF PA
Entity Type:Organization
Organization Name:DONALD J. KRIPPENDORF PA
Other - Org Name:FLORIDA CHIROPRACTIC INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:KRIPPENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-544-7878
Mailing Address - Street 1:4641 PARK STREET NORTH
Mailing Address - Street 2:
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709
Mailing Address - Country:US
Mailing Address - Phone:727-544-7878
Mailing Address - Fax:727-546-9253
Practice Address - Street 1:4641 PARK STREET NORTH
Practice Address - Street 2:
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709
Practice Address - Country:US
Practice Address - Phone:727-544-7878
Practice Address - Fax:727-546-9253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38496OtherBLUE CROSS/BLUE SHIELD GR
FL38496OtherBLUE CROSS/BLUE SHIELD GR