Provider Demographics
NPI:1235354788
Name:MAGNANO HEALTH CENTER LLC.
Entity Type:Organization
Organization Name:MAGNANO HEALTH CENTER LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:MAGNANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-408-5222
Mailing Address - Street 1:1857 GULF TO BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-3415
Mailing Address - Country:US
Mailing Address - Phone:727-408-5222
Mailing Address - Fax:727-408-5222
Practice Address - Street 1:1857 GULF TO BAY BLVD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-3415
Practice Address - Country:US
Practice Address - Phone:727-408-5222
Practice Address - Fax:727-408-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9225111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty