Provider Demographics
NPI:1558699348
Name:DISC & SPINE CARE CENTER LLC
Entity Type:Organization
Organization Name:DISC & SPINE CARE CENTER LLC
Other - Org Name:STRUBBE CHIROPRACTIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MARSHALL
Authorized Official - Last Name:STRUBBE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-541-6800
Mailing Address - Street 1:5687 PARK BLVD N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3330
Mailing Address - Country:US
Mailing Address - Phone:727-541-6800
Mailing Address - Fax:727-544-4148
Practice Address - Street 1:5687 PARK BLVD N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3330
Practice Address - Country:US
Practice Address - Phone:727-541-6800
Practice Address - Fax:727-544-4148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5663111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL051049100Medicaid
FL051049100Medicaid
T83202Medicare UPIN