Provider Demographics
NPI:1619745973
Name:NEUROPLASTICITY ST. PETE LLC
Entity Type:Organization
Organization Name:NEUROPLASTICITY ST. PETE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SILVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-292-4205
Mailing Address - Street 1:2370 9TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-3239
Mailing Address - Country:US
Mailing Address - Phone:818-292-4205
Mailing Address - Fax:
Practice Address - Street 1:2370 9TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-3239
Practice Address - Country:US
Practice Address - Phone:818-292-4205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty