Provider Demographics
NPI:1841404241
Name:DR TANYA SCHRUMPF DC INC
Entity Type:Organization
Organization Name:DR TANYA SCHRUMPF DC INC
Other - Org Name:FLORIDA SPINAL REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:NANETTE
Authorized Official - Last Name:SCHRUMPF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:321-267-0188
Mailing Address - Street 1:3206 S HOPKINS AVE
Mailing Address - Street 2:SUITE 19
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-5667
Mailing Address - Country:US
Mailing Address - Phone:321-267-0188
Mailing Address - Fax:321-267-0611
Practice Address - Street 1:2210 CHENEY HWY
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-6702
Practice Address - Country:US
Practice Address - Phone:321-267-0188
Practice Address - Fax:321-267-0611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9229111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL62063OtherBCBS OF FLORIDA
FL1205832565OtherNPI - DR TANYA SCHRUMPF
FL5795559OtherAETNA - PPO (RCN)
FL0206583OtherCIGNA
FL928556OtherAETNA - HMO (RCN)
FL0206583OtherCIGNA