Provider Demographics
NPI:1750384582
Name:CULLINANE, JOHN FRANCIS (D C)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FRANCIS
Last Name:CULLINANE
Suffix:
Gender:M
Credentials:D C
Other - Prefix:DR
Other - First Name:JAY
Other - Middle Name:
Other - Last Name:CULLINANE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:D C
Mailing Address - Street 1:1106 10TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-3332
Mailing Address - Country:US
Mailing Address - Phone:407-892-5008
Mailing Address - Fax:407-982-5028
Practice Address - Street 1:1106 10TH ST
Practice Address - Street 2:STE B
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-3334
Practice Address - Country:US
Practice Address - Phone:407-892-5008
Practice Address - Fax:407-892-5028
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6290111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL052561800Medicaid
T34539Medicare UPIN
FL052561800Medicaid