Provider Demographics
NPI:1083994420
Name:JOHN S VIRGA DCPA
Entity Type:Organization
Organization Name:JOHN S VIRGA DCPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:VIRGA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-889-0889
Mailing Address - Street 1:4624 HOLLYWOOD BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6526
Mailing Address - Country:US
Mailing Address - Phone:305-889-0889
Mailing Address - Fax:305-889-1749
Practice Address - Street 1:4624 HOLLYWOOD BLVD STE 206
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6526
Practice Address - Country:US
Practice Address - Phone:305-889-0889
Practice Address - Fax:305-889-1749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6250111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22984Medicaid
FLU4879Medicare UPIN