Individual provider Active NPI

Evan Micheal Frobose, D.C.

  • Chiropractor
  • Edgewater, FL
National Provider Identifier
1134711484
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13411 Issued in FL
Practice address
315 N Ridgewood Ave
Edgewater, FL 32132-1617
Phone
(386) 427-8403
NPI assigned
Feb 8, 2021
Last updated
Feb 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 13411 FL Primary

Addresses

Primary practice location

315 N Ridgewood Ave
Edgewater, FL 32132-1617

Mailing address

280 Braeburn Cir
Daytona Beach, FL 32114-7188
Phone (570) 899-2292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13411FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1134711484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 BRAEBURN CIR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321147188",
            "telephone_number": "570-899-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N RIDGEWOOD AVE",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321321617",
            "telephone_number": "386-427-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROBOSE",
        "first_name": "EVAN",
        "middle_name": "MICHEAL",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "13411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.