Provider Demographics
NPI:1770703092
Name:SUNSET CHIROPRACTIC ASSOCIATES PA
Entity type:Organization
Organization Name:SUNSET CHIROPRACTIC ASSOCIATES PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:MAURNO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-666-4449
Mailing Address - Street 1:7575 SW 62ND AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143
Mailing Address - Country:US
Mailing Address - Phone:305-666-4449
Mailing Address - Fax:305-666-4749
Practice Address - Street 1:7575 SW 62ND AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143
Practice Address - Country:US
Practice Address - Phone:305-666-4449
Practice Address - Fax:305-666-4749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007476111N00000X
FLCH4746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty