Provider Demographics
NPI:1548398241
Name:RACINE, STEVE (DC)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:
Last Name:RACINE
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 1:6916 ALOMA AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792
Mailing Address - Country:US
Mailing Address - Phone:407-677-8881
Mailing Address - Fax:407-677-0705
Practice Address - Street 1:6916 ALOMA AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-7003
Practice Address - Country:US
Practice Address - Phone:407-677-8881
Practice Address - Fax:407-677-0705
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8251111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01-0643852OtherTAX ID
FL01-0643852OtherTAX ID
FLU89875Medicare UPIN