Organization Active NPI

Divine UC Chiropractic, PLLC

  • Chiropractor
  • Indian Harbour Beach, FL
National Provider Identifier
1093527129
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DIVINE UC CHIROPRACTIC, PLLC
Practice address
250 E Eau Gallie Blvd
Indian Harbour Beach, FL 32937-4874
Phone
(321) 241-4801
NPI assigned
Jan 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Rosa Elena Vince, DCNPI 1114084852
Title
Chiropractor
Phone
(415) 902-9009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

250 E Eau Gallie Blvd
Indian Harbour Beach, FL 32937-4874

Mailing address

250 E Eau Gallie Blvd
Indian Harbour Beach, FL 32937-4874
Phone (321) 241-4801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250306002021 FL Part B Supplier - Clinic/Group Practice 1658892658 Receives reassigned benefits from 2 practitioners
Practice locations: Indian Harbour Beach, FL

National Provider Directory

National Provider Directory

Locations

250 E Eau Gallie Blvd
Indian Harbour Beach, FL 32937
Phone (321) 241-4801

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737676800000",
    "number": "1093527129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E EAU GALLIE BLVD",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329374874",
            "telephone_number": "321-241-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E EAU GALLIE BLVD",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329374874",
            "telephone_number": "321-241-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE UC CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-24",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "VINCE",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "ELENA",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "415-902-9009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Harbour Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.