Provider Demographics
NPI:1598094484
Name:SHIMONI, AMOS E (DC)
Entity Type:Individual
Prefix:DR
First Name:AMOS
Middle Name:E
Last Name:SHIMONI
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 1:108 PARK PLACE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-6877
Mailing Address - Country:US
Mailing Address - Phone:863-353-6145
Mailing Address - Fax:863-353-6145
Practice Address - Street 1:4125 HUNTERS PARK LN STE 117
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7615
Practice Address - Country:US
Practice Address - Phone:845-344-1211
Practice Address - Fax:845-344-4045
Is Sole Proprietor?:No
Enumeration Date:2009-12-23
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor