Provider Demographics
NPI:1487868188
Name:PREISS, DAVID CRAIG (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CRAIG
Last Name:PREISS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19050 SAN CARLOS BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33931-2219
Mailing Address - Country:US
Mailing Address - Phone:239-765-0600
Mailing Address - Fax:239-765-1461
Practice Address - Street 1:19050 SAN CARLOS BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS BEACH
Practice Address - State:FL
Practice Address - Zip Code:33931-2219
Practice Address - Country:US
Practice Address - Phone:239-765-0600
Practice Address - Fax:239-765-1461
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4048111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88905Medicare ID - Type UnspecifiedPROVIDER NUMBER