Provider Demographics
NPI:1114167137
Name:RIVERVIEW CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:RIVERVIEW CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MINAFRI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-677-2700
Mailing Address - Street 1:10732 KETCHUM VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-7185
Mailing Address - Country:US
Mailing Address - Phone:813-677-2700
Mailing Address - Fax:813-677-6355
Practice Address - Street 1:10732 KETCHUM VALLEY DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-7185
Practice Address - Country:US
Practice Address - Phone:813-677-2700
Practice Address - Fax:813-677-6355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8230Medicare PIN