Provider Demographics
NPI:1982663696
Name:ADAN, PAMELA (DC)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:ADAN
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 1:1437 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3816
Mailing Address - Country:US
Mailing Address - Phone:772-589-6413
Mailing Address - Fax:772-589-0422
Practice Address - Street 1:1437 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3816
Practice Address - Country:US
Practice Address - Phone:772-589-6413
Practice Address - Fax:772-589-0422
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2008-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22584Medicare ID - Type Unspecified