Provider Demographics
NPI:1568597748
Name:C. DAX MAGGIORE, D.C., P.A.
Entity Type:Organization
Organization Name:C. DAX MAGGIORE, D.C., P.A.
Other - Org Name:MAGGIORE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DAX
Authorized Official - Last Name:MAGGIORE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:772-286-3650
Mailing Address - Street 1:915 E. OCEAN BLVD.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2426
Mailing Address - Country:US
Mailing Address - Phone:772-286-3650
Mailing Address - Fax:772-286-2649
Practice Address - Street 1:915 E OCEAN BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2426
Practice Address - Country:US
Practice Address - Phone:772-286-3650
Practice Address - Fax:772-286-2649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7526111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00301101OtherRAILROAD RETIREMENT BOARD
FL55934OtherBLUE CROSS BLUE SHIELD
FL55934AMedicare ID - Type UnspecifiedMEDICARE PROVIDER ID
FLP00301101OtherRAILROAD RETIREMENT BOARD