Provider Demographics
NPI:1982877262
Name:LAUREN BIRKS, PA
Entity Type:Organization
Organization Name:LAUREN BIRKS, PA
Other - Org Name:SUNCOAST CHIROPRACTIC & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-360-2428
Mailing Address - Street 1:5899 WHITFIELD AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-6152
Mailing Address - Country:US
Mailing Address - Phone:941-360-2428
Mailing Address - Fax:941-360-2418
Practice Address - Street 1:5899 WHITFIELD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-6152
Practice Address - Country:US
Practice Address - Phone:941-360-2428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8302111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7763Medicare UPIN