Provider Demographics
NPI:1265569339
Name:BADALA, FRANK JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JAMES
Last Name:BADALA
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 1:7121 MOSS LEDGE RUN
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34637
Mailing Address - Country:US
Mailing Address - Phone:727-534-9378
Mailing Address - Fax:
Practice Address - Street 1:15901 N. FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549
Practice Address - Country:US
Practice Address - Phone:727-534-9378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010906111N00000X
FLCH9637111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX7N251Medicare ID - Type UnspecifiedMEDICARE IDENTIFICATION #