Provider Demographics
NPI:1265620595
Name:UNIVERSITY CHIROPRACTIC CENTER, INC.
Entity type:Organization
Organization Name:UNIVERSITY CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:BRADY
Authorized Official - Last Name:ARNSPERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-360-2220
Mailing Address - Street 1:8233 COOPER CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:FL
Mailing Address - Zip Code:34201-2009
Mailing Address - Country:US
Mailing Address - Phone:941-360-2220
Mailing Address - Fax:941-360-2229
Practice Address - Street 1:5245 UNIVERSITY PKWY UNIT 101
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:FL
Practice Address - Zip Code:34201-3011
Practice Address - Country:US
Practice Address - Phone:941-360-2220
Practice Address - Fax:941-360-2229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363LP2300X, 207QA0505X
FLCH7921111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381741500Medicaid
FLK5375Medicare PIN