Provider Demographics
NPI:1912001439
Name:CHOATE, DAVID WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WAYNE
Last Name:CHOATE
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 1:1828 S FLORIDA AVENUE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-2654
Mailing Address - Country:US
Mailing Address - Phone:863-913-1240
Mailing Address - Fax:863-913-1243
Practice Address - Street 1:1828 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-2654
Practice Address - Country:US
Practice Address - Phone:863-913-1240
Practice Address - Fax:863-913-1243
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5716111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22232OtherBCBS
FL22232OtherBCBS
FL22232ZMedicare PIN