Provider Demographics
NPI:1245329259
Name:NAHALI, DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:NAHALI
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 1:11333 LAKE UNDERHILL RD
Mailing Address - Street 2:SUITE. 105
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5091
Mailing Address - Country:US
Mailing Address - Phone:407-277-0033
Mailing Address - Fax:407-650-2550
Practice Address - Street 1:11333 LAKE UNDERHILL ROAD
Practice Address - Street 2:SUITE 105
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825
Practice Address - Country:US
Practice Address - Phone:407-277-0033
Practice Address - Fax:407-650-2550
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8054111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0070206Medicare UPIN