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Contact Information

1 SOURCE CHIROPRACTIC & PHYSICAL MEDICINE CENTER INC
2718 LETAP CT
LAND O' LAKES, FL34638-7218
 Phone: 813-448-2222
 Fax: 813-948-7111
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
 

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for 1 SOURCE CHIROPRACTIC & PHYSICAL MEDICINE CENTER INC

NPI # 1235481524
LBN Legal business name 1 SOURCE CHIROPRACTIC & PHYSICAL MEDICINE CENTER INC
Authorized official JORGE SANTANA - (OWNER/DOCTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/10/2012
Last updated 01/22/2013 - About 13 years ago
Identifiers
FL License # CH8357
FL License # ME114962
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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