Advanced Wellness & Sports Rehab, LLC

Key facts

NPI: 1134481005
Entity type: Organization (NPI type 2)
Primary specialty: Sports Physician Chiropractor 111NS0005X
License: CH10458 (FL)
Legal business name: ADVANCED WELLNESS & SPORTS REHAB, LLC
Practice address: 14028 5TH St
Dade City, FL 33525
Phone: (352) 600-2232
Fax: (352) 292-0136
NPI assigned: Jun 15, 2012
Organization subpart: No

Authorized official

Name: Dr. Philip A Snyder, DC
Title: Owner
Phone: (724) 875-2460

Practitioners 1

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

Philip A Snyder, D.C. Chiropractor · Dade City, FL · NPI 1942586466

Medicare reassignment NPD FL

Medicare participation

Medicare fee-for-service enrollment: Enrolled in FL

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20190221000298	FL	Part B Supplier - Clinic/Group Practice	3375846926	Receives reassigned benefits from 1 practitioner Practice locations: Dade City, FL

National Provider Directory

Locations

14028 5th St
Ste A
Dade City, FL 33525
Phone (352) 600-2232

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Sports Physician Chiropractor Group: 193200000X MULTI-SPECIALTY GROUP	111NS0005X	CH10458	FL	Yes

Addresses

Primary practice location

14028 5TH St
Dade City, FL 33525

Mailing address

14028 5TH St
Dade City, FL 33525-4311
Phone (352) 600-2232

Other practice location 1

5413 George St Ste 1
New Port Richey, FL 34652-4101
Phone (352) 600-2232

Other practice location 2

14028 5th St
Dade City, FL 33525
Phone (352) 600-2232

Other providers in Dade City, FL

Mazen A Abboud, DPM
Salam N Abdo, APRN
Jade Alexis Abrams, RD, LD/N
Miranda Adams, APRN, FNP-BC
Yetunde O Adedeji, DDS
Adventhealth Home Health and Hospice Inc
Safi Uddin Ahmed, MD
Danielle L Albritton, DO
Angela Alcover, RCSWI
Kayla Allen

All providers in Dade City, FL · Sports Physician Chiropractor in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.