Provider Demographics
NPI:1184972077
Name:A-A SUNCOAST CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:A-A SUNCOAST CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:KING
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:ANDRION
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:727-321-2020
Mailing Address - Street 1:5025 9TH AVE N
Mailing Address - Street 2:SUITE A
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-6606
Mailing Address - Country:US
Mailing Address - Phone:727-321-2020
Mailing Address - Fax:727-323-1583
Practice Address - Street 1:5025 9TH AVE N
Practice Address - Street 2:SUITE A
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-6606
Practice Address - Country:US
Practice Address - Phone:727-321-2020
Practice Address - Fax:727-323-1583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL593147022111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty