Provider Demographics
NPI:1508953183
Name:ROSEWOOD CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:ROSEWOOD CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BALLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-991-5450
Mailing Address - Street 1:2142 ASHLEY OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-7023
Mailing Address - Country:US
Mailing Address - Phone:813-991-5450
Mailing Address - Fax:813-991-5493
Practice Address - Street 1:2142 ASHLEY OAKS CIR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-7023
Practice Address - Country:US
Practice Address - Phone:813-991-5450
Practice Address - Fax:813-991-5493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004163111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT-55673Medicare UPIN
FL88073Medicare ID - Type Unspecified