Provider Demographics
NPI:1245447648
Name:SOSA FAMILY CHIROPRACTIC CENTER PA
Entity type:Organization
Organization Name:SOSA FAMILY CHIROPRACTIC CENTER PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:SOSA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-855-2424
Mailing Address - Street 1:10981 COUNTRYWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626
Mailing Address - Country:US
Mailing Address - Phone:813-855-2424
Mailing Address - Fax:813-855-5551
Practice Address - Street 1:10981 COUNTRYWAY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626
Practice Address - Country:US
Practice Address - Phone:813-855-2424
Practice Address - Fax:813-855-5551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6521111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAD006OtherPROVIDER IDENTIFIER