Provider Demographics
NPI:1386834653
Name:INATY, OMAR A (DC)
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:A
Last Name:INATY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:OMAR
Other - Middle Name:A
Other - Last Name:INATY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:2026 ASHLEY OAKS CIR
Mailing Address - Street 2:STE 102
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-7011
Mailing Address - Country:US
Mailing Address - Phone:813-994-6507
Mailing Address - Fax:813-345-4057
Practice Address - Street 1:2026 ASHLEY OAKS CIR
Practice Address - Street 2:STE 102
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-7011
Practice Address - Country:US
Practice Address - Phone:813-994-6507
Practice Address - Fax:813-345-4057
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH00005704111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22430Medicare PIN
FLU47282Medicare UPIN