Provider Demographics
NPI:1275714941
Name:CARLOS E. ZULUAGA DCPA
Entity Type:Organization
Organization Name:CARLOS E. ZULUAGA DCPA
Other - Org Name:HUNTER'S CROSSING CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:ZULUAGA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-378-8500
Mailing Address - Street 1:4631 NW 53RD AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-8302
Mailing Address - Country:US
Mailing Address - Phone:352-378-8500
Mailing Address - Fax:
Practice Address - Street 1:4631 NW 53RD AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-8302
Practice Address - Country:US
Practice Address - Phone:352-378-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6844111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU62404Medicare UPIN
FL55448Medicare PIN