Provider Demographics
NPI:1821018300
Name:LAPINEFAMILYCHIROPRACTICCLINIC,INC.
Entity type:Organization
Organization Name:LAPINEFAMILYCHIROPRACTICCLINIC,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LAPINE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:321-872-0770
Mailing Address - Street 1:5201 BABCOCK ST NE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-4637
Mailing Address - Country:US
Mailing Address - Phone:321-872-0770
Mailing Address - Fax:321-872-0772
Practice Address - Street 1:5201 BABCOCK ST NE
Practice Address - Street 2:SUITE 1
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-4637
Practice Address - Country:US
Practice Address - Phone:321-872-0770
Practice Address - Fax:321-872-0772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAM493Medicare PIN
FL60003YMedicare UPIN