Provider Demographics
NPI:1285026849
Name:BRENT C OSTRANDER, DC, LLC
Entity Type:Organization
Organization Name:BRENT C OSTRANDER, DC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:C
Authorized Official - Last Name:OSTRANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-522-6600
Mailing Address - Street 1:7000 48TH ST N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-4409
Mailing Address - Country:US
Mailing Address - Phone:727-522-6600
Mailing Address - Fax:727-525-7003
Practice Address - Street 1:7000 48TH ST N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-4409
Practice Address - Country:US
Practice Address - Phone:727-522-6600
Practice Address - Fax:727-525-7003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11366261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty