Provider Demographics
NPI:1932470317
Name:SHAFFER CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:SHAFFER CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SHAFFER
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:407-282-6008
Mailing Address - Street 1:5430 HOFFNER AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-2501
Mailing Address - Country:US
Mailing Address - Phone:407-282-6008
Mailing Address - Fax:
Practice Address - Street 1:5430 HOFFNER AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-2501
Practice Address - Country:US
Practice Address - Phone:407-282-6008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0005032111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1518018357OtherPERSONAL NPI
FL70703Medicare PIN
FL1518018357OtherPERSONAL NPI