Provider Demographics
NPI:1770619587
Name:NALDA, ANTHONY G (DC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:G
Last Name:NALDA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-4675
Mailing Address - Country:US
Mailing Address - Phone:321-939-2328
Mailing Address - Fax:407-965-4485
Practice Address - Street 1:604 FRONT ST
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-4675
Practice Address - Country:US
Practice Address - Phone:321-939-2328
Practice Address - Fax:407-965-4485
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL463786867OtherTAX ID
FL55655OtherBCBS
FL381121200Medicaid
FL55655Medicare ID - Type Unspecified