Provider Demographics
NPI:1366674764
Name:DR REID DCPA
Entity Type:Organization
Organization Name:DR REID DCPA
Other - Org Name:HOPE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-381-3880
Mailing Address - Street 1:1135 PROFESSIONAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4887
Mailing Address - Country:US
Mailing Address - Phone:813-381-3880
Mailing Address - Fax:813-381-3881
Practice Address - Street 1:1135 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4887
Practice Address - Country:US
Practice Address - Phone:813-381-3880
Practice Address - Fax:813-381-3881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381730000Medicaid
FL381730000Medicaid
FL70419Medicare PIN