Provider Demographics
NPI:1366457137
Name:CORRITORI, SANDY BRAVAR (DC)
Entity Type:Individual
Prefix:DR
First Name:SANDY
Middle Name:BRAVAR
Last Name:CORRITORI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 PGA BLVD
Mailing Address - Street 2:SUITE 104A
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-3900
Mailing Address - Country:US
Mailing Address - Phone:561-632-6822
Mailing Address - Fax:
Practice Address - Street 1:5600 P G A BLVD
Practice Address - Street 2:SUITE 104A
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-3900
Practice Address - Country:US
Practice Address - Phone:561-632-6822
Practice Address - Fax:561-624-4349
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor