Provider Demographics
NPI:1417364365
Name:GULF BREEZE CHIROPRACTIC AND WELLNESS, LLC
Entity Type:Organization
Organization Name:GULF BREEZE CHIROPRACTIC AND WELLNESS, LLC
Other - Org Name:SHELBY PLANTE MS, DC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:
Authorized Official - Last Name:PLANTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-397-1000
Mailing Address - Street 1:9303 SEMINOLE BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-3100
Mailing Address - Country:US
Mailing Address - Phone:727-397-1000
Mailing Address - Fax:
Practice Address - Street 1:9303 SEMINOLE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-3100
Practice Address - Country:US
Practice Address - Phone:727-397-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-11
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11120111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty