Provider Demographics
NPI:1245771641
Name:WINTER SPRINGS SPINE AND WELLNESS
Entity Type:Organization
Organization Name:WINTER SPRINGS SPINE AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOPPA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-695-4800
Mailing Address - Street 1:1340 TUSKAWILLA RD STE 112
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5030
Mailing Address - Country:US
Mailing Address - Phone:407-695-4800
Mailing Address - Fax:407-695-7887
Practice Address - Street 1:1340 TUSKAWILLA RD STE 112
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5030
Practice Address - Country:US
Practice Address - Phone:407-695-4800
Practice Address - Fax:407-695-7887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9210111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty