Provider Demographics
NPI:1902815442
Name:SARBAK, TODD DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:DAVID
Last Name:SARBAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 11TH LN
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-2134
Mailing Address - Country:US
Mailing Address - Phone:772-713-4341
Mailing Address - Fax:772-562-4411
Practice Address - Street 1:973 37TH PL
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6541
Practice Address - Country:US
Practice Address - Phone:772-713-4341
Practice Address - Fax:772-562-4411
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8015111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL53929Medicare PIN