Provider Demographics
NPI:1720439847
Name:R. BRADLEY KOSER DC, LLC
Entity Type:Organization
Organization Name:R. BRADLEY KOSER DC, LLC
Other - Org Name:SEMINOLE HEIGHTS CHIROPRACTIC & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:KOSER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:813-702-5566
Mailing Address - Street 1:5805 N FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-6601
Mailing Address - Country:US
Mailing Address - Phone:813-702-5566
Mailing Address - Fax:888-511-0039
Practice Address - Street 1:5805 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-6601
Practice Address - Country:US
Practice Address - Phone:813-702-5566
Practice Address - Fax:888-511-0039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-29
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty