Provider Demographics
NPI:1457521601
Name:WEST COAST CHIROPRACTIC & MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:WEST COAST CHIROPRACTIC & MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-495-5648
Mailing Address - Street 1:8502 N ARMENIA AVE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-2567
Mailing Address - Country:US
Mailing Address - Phone:813-933-9295
Mailing Address - Fax:813-933-9325
Practice Address - Street 1:8502 N ARMENIA AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-2567
Practice Address - Country:US
Practice Address - Phone:813-933-9295
Practice Address - Fax:813-933-9325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8381261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty