Provider Demographics
NPI:1477804250
Name:RONALD LATRONICA DC PA
Entity Type:Organization
Organization Name:RONALD LATRONICA DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LATRONICA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-633-3332
Mailing Address - Street 1:955 E DEL WEBB BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573
Mailing Address - Country:US
Mailing Address - Phone:813-633-3332
Mailing Address - Fax:813-633-0564
Practice Address - Street 1:955 E DEL WEBB BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-6670
Practice Address - Country:US
Practice Address - Phone:813-633-3332
Practice Address - Fax:813-633-0564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5339111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL204877901Medicaid
FLT55065Medicare UPIN
FL70859Medicare PIN