Provider Demographics
NPI:1457572489
Name:DARDANO CHIROPRACTIC INC
Entity Type:Organization
Organization Name:DARDANO CHIROPRACTIC INC
Other - Org Name:DARDANO WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING REPRESENTATIVE
Authorized Official - Prefix:PROF
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HILDERLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-232-0470
Mailing Address - Street 1:6800 N DALE MABRY HWY
Mailing Address - Street 2:#120
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-3997
Mailing Address - Country:US
Mailing Address - Phone:813-882-9355
Mailing Address - Fax:813-882-0044
Practice Address - Street 1:6800 N DALE MABRY HWY
Practice Address - Street 2:#120
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3997
Practice Address - Country:US
Practice Address - Phone:813-882-9355
Practice Address - Fax:813-882-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9268111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL90385OtherBLUE CROSS BLUE SHIELD