Provider Demographics
NPI:1831267160
Name:YINGLING, GREGORY ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ALAN
Last Name:YINGLING
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 1:5290 SEMINOLE BLVD
Mailing Address - Street 2:SUITE A & B
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33708-3369
Mailing Address - Country:US
Mailing Address - Phone:727-398-2988
Mailing Address - Fax:727-398-5025
Practice Address - Street 1:5290 SEMINOLE BLVD
Practice Address - Street 2:SUITE A & B
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33708-3369
Practice Address - Country:US
Practice Address - Phone:727-398-2988
Practice Address - Fax:727-398-5025
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8471111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650831OtherUNITED HEALTH CARE I.D.
FLCH 8471OtherFLORIDA LICENSE #
FL34975-88137ZOtherBLUE CROSS BLUE SHIELD
FLG3217969OtherFIRST HEALTH NETWORK I.D.
FLCH 8471OtherFLORIDA LICENSE #
FL650831OtherUNITED HEALTH CARE I.D.