Provider Demographics
NPI:1407076169
Name:FAMILY CHIROPRACTIC INC
Entity Type:Organization
Organization Name:FAMILY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAFEEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-924-7228
Mailing Address - Street 1:3529 S TUTTLE AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-6406
Mailing Address - Country:US
Mailing Address - Phone:941-924-7228
Mailing Address - Fax:
Practice Address - Street 1:3529 S TUTTLE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-6406
Practice Address - Country:US
Practice Address - Phone:941-924-7228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88734OtherBCBS
FL88734OtherBCBS
FL1407076169Medicare PIN