Provider Demographics
NPI:1780799353
Name:GADOMSKI, ALBERT JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:JOSEPH
Last Name:GADOMSKI
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 1:230 PINE AVE N
Mailing Address - Street 2:STE B
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-4677
Mailing Address - Country:US
Mailing Address - Phone:813-854-1177
Mailing Address - Fax:813-855-2215
Practice Address - Street 1:230 PINE AVE N
Practice Address - Street 2:STE B
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-4677
Practice Address - Country:US
Practice Address - Phone:813-854-1177
Practice Address - Fax:813-855-2215
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005272111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3811051-00Medicaid
FL22562OtherBCBS
FLU08352Medicare UPIN