Provider Demographics
NPI:1659563674
Name:DR PAUL J CANALI DC PA
Entity Type:Organization
Organization Name:DR PAUL J CANALI DC PA
Other - Org Name:EVOLUTIONARY HEALING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CANALI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-667-8174
Mailing Address - Street 1:7800 S RED RD
Mailing Address - Street 2:SUITE PH 325
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5528
Mailing Address - Country:US
Mailing Address - Phone:305-667-8174
Mailing Address - Fax:305-661-2312
Practice Address - Street 1:7800 S RED RD
Practice Address - Street 2:SUITE PH 325
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5528
Practice Address - Country:US
Practice Address - Phone:305-667-8174
Practice Address - Fax:305-661-2312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88030OtherBC BS