Provider Demographics
NPI:1619488624
Name:THRIVE FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:THRIVE FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PADILLA BRAVO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:904-437-4546
Mailing Address - Street 1:1616 JORK RD STE 302
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-2494
Mailing Address - Country:US
Mailing Address - Phone:904-437-4546
Mailing Address - Fax:904-437-4546
Practice Address - Street 1:1616 JORK RD STE 302
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-2494
Practice Address - Country:US
Practice Address - Phone:904-437-4546
Practice Address - Fax:904-437-4546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-17
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL11601111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty