Provider Demographics
NPI:1891572269
Name:THORASSIC PARK TOO
Entity Type:Organization
Organization Name:THORASSIC PARK TOO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:R
Authorized Official - Last Name:RANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-773-3404
Mailing Address - Street 1:3062 UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2502
Mailing Address - Country:US
Mailing Address - Phone:941-251-8739
Mailing Address - Fax:
Practice Address - Street 1:3062 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2502
Practice Address - Country:US
Practice Address - Phone:941-251-8739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty