Provider Demographics
NPI:1245236108
Name:DAVID B. MANKOWITZ D.C., P.A.
Entity Type:Organization
Organization Name:DAVID B. MANKOWITZ D.C., P.A.
Other - Org Name:MANKOWITZ CHIROPRACTIC AND MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:MANKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-922-4444
Mailing Address - Street 1:4970 FRUITVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232
Mailing Address - Country:US
Mailing Address - Phone:941-922-4444
Mailing Address - Fax:941-377-9010
Practice Address - Street 1:4970 FRUITVILLE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-2261
Practice Address - Country:US
Practice Address - Phone:941-922-4444
Practice Address - Fax:941-377-9010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-24
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006241111N00000X
FLCH6241111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
49786Medicare UPIN
FL22587Medicare ID - Type Unspecified