Provider Demographics
NPI:1588001796
Name:PALMA CEIA CHIROPRACTIC AND WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:PALMA CEIA CHIROPRACTIC AND WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DEX
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-251-0246
Mailing Address - Street 1:1502 S MACDILL AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-5214
Mailing Address - Country:US
Mailing Address - Phone:813-251-0246
Mailing Address - Fax:813-254-5293
Practice Address - Street 1:1502 S MACDILL AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5214
Practice Address - Country:US
Practice Address - Phone:813-251-0246
Practice Address - Fax:813-254-5293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty