Provider Demographics
NPI:1477667129
Name:KEY WEST CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:KEY WEST CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-296-5626
Mailing Address - Street 1:1010 KENNEDY DR. SUITE 401
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040
Mailing Address - Country:US
Mailing Address - Phone:305-296-5626
Mailing Address - Fax:305-293-0010
Practice Address - Street 1:1010 KENNEDY DR STE 401
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4134
Practice Address - Country:US
Practice Address - Phone:305-296-5626
Practice Address - Fax:305-293-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2917111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381044500Medicaid
FL88473Medicare ID - Type Unspecified