Provider Demographics
NPI:1841564002
Name:FIORE CHIROPRACTIC OFFICE
Entity Type:Organization
Organization Name:FIORE CHIROPRACTIC OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:FIORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-276-5433
Mailing Address - Street 1:637 BLANDING BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-5029
Mailing Address - Country:US
Mailing Address - Phone:904-276-5433
Mailing Address - Fax:904-272-5546
Practice Address - Street 1:637 BLANDING BLVD STE 3
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5029
Practice Address - Country:US
Practice Address - Phone:904-276-5433
Practice Address - Fax:904-272-5546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4727111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH4727OtherLICENSE
FLCH4727OtherLICENSE