Provider Demographics
NPI:1174291561
Name:SPINAL SOLUTIONS FL LLC
Entity Type:Organization
Organization Name:SPINAL SOLUTIONS FL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:HEGARTY
Authorized Official - Suffix:
Authorized Official - Credentials:DC,
Authorized Official - Phone:916-800-4947
Mailing Address - Street 1:2933 S FLORIDA AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4037
Mailing Address - Country:US
Mailing Address - Phone:916-800-4947
Mailing Address - Fax:407-738-4167
Practice Address - Street 1:2933 S FLORIDA AVE STE 7
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4037
Practice Address - Country:US
Practice Address - Phone:916-800-4947
Practice Address - Fax:407-738-4167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty