Provider Demographics
NPI:1093930323
Name:DR RICHARD M TAMBE D C PA
Entity Type:Organization
Organization Name:DR RICHARD M TAMBE D C PA
Other - Org Name:TAMBE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:TAMBE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-518-6126
Mailing Address - Street 1:PO BOX 20068
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34204-0068
Mailing Address - Country:US
Mailing Address - Phone:941-518-6126
Mailing Address - Fax:
Practice Address - Street 1:6815 14TH ST W
Practice Address - Street 2:SUITE 107
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-5810
Practice Address - Country:US
Practice Address - Phone:941-518-6126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7635111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55919Medicare ID - Type Unspecified
FLU82987Medicare UPIN