Provider Demographics
NPI:1891836508
Name:GIUSTO-LOCKWOOD, PAULA T (DC)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:T
Last Name:GIUSTO-LOCKWOOD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 S MACDILL AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-5934
Mailing Address - Country:US
Mailing Address - Phone:813-253-2565
Mailing Address - Fax:813-253-3667
Practice Address - Street 1:2102 S MACDILL AVE
Practice Address - Street 2:SUITE C
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5934
Practice Address - Country:US
Practice Address - Phone:813-253-2565
Practice Address - Fax:813-253-3667
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7103111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55384Medicare ID - Type UnspecifiedMEDICARE AND BC&BS #