Provider Demographics
NPI:1386019974
Name:GIANETTI CHIROPRACTIC CENTER P.A.
Entity Type:Organization
Organization Name:GIANETTI CHIROPRACTIC CENTER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:GIANETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-301-2319
Mailing Address - Street 1:27400 RIVERVIEW CENTER BLVD
Mailing Address - Street 2:STE. 1
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-4324
Mailing Address - Country:US
Mailing Address - Phone:239-301-2319
Mailing Address - Fax:239-301-0435
Practice Address - Street 1:27400 RIVERVIEW CENTER BLVD
Practice Address - Street 2:STE. 1
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-4324
Practice Address - Country:US
Practice Address - Phone:239-301-2319
Practice Address - Fax:239-301-0435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012987800Medicaid
FL1477520609OtherINDIVIDUAL NPI