Provider Demographics
NPI:1417162371
Name:ADVANCED CHIROPRACTIC ASSOCIATES, INC.
Entity Type:Organization
Organization Name:ADVANCED CHIROPRACTIC ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:FILIMON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-848-2663
Mailing Address - Street 1:8406 MASSACHUSETTS AVE STE A2
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-3129
Mailing Address - Country:US
Mailing Address - Phone:727-848-2663
Mailing Address - Fax:727-845-4093
Practice Address - Street 1:8406 MASSACHUSETTS AVE STE A2
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-3129
Practice Address - Country:US
Practice Address - Phone:727-848-2663
Practice Address - Fax:727-845-4093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU91095Medicare UPIN
FLK2544Medicare ID - Type Unspecified