Provider Demographics
NPI:1497822506
Name:ALBANY SLIGH CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:ALBANY SLIGH CHIROPRACTIC CLINIC INC
Other - Org Name:TINARI CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TINARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-875-7900
Mailing Address - Street 1:19439 SHUMARD OAK DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-7262
Mailing Address - Country:US
Mailing Address - Phone:813-875-7900
Mailing Address - Fax:813-875-7930
Practice Address - Street 1:19439 SHUMARD OAK DR
Practice Address - Street 2:SUITE 101
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-7262
Practice Address - Country:US
Practice Address - Phone:813-875-7900
Practice Address - Fax:813-875-7930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9039111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019312500Medicaid
FLAG109Medicare PIN