Provider Demographics
NPI:1952633273
Name:SW FLORIDA CHIROPRACTIC CENTER, INC
Entity Type:Organization
Organization Name:SW FLORIDA CHIROPRACTIC CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAZ
Authorized Official - Middle Name:D
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-348-7600
Mailing Address - Street 1:2014 SANTA BARBARA BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-5446
Mailing Address - Country:US
Mailing Address - Phone:239-348-7600
Mailing Address - Fax:239-348-7601
Practice Address - Street 1:2014 SANTA BARBARA BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-5446
Practice Address - Country:US
Practice Address - Phone:239-348-7600
Practice Address - Fax:239-348-7601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4496261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAC032ZMedicare PIN
FLT84437Medicare UPIN