Conforti'S Crossroads Chiropractic Inc.
Organization Active NPI Chiropractor · Trinity, FL
NPI 1164568796 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1164568796
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- CH7068 (FL)
- Legal business name
- CONFORTI'S CROSSROADS CHIROPRACTIC INC.
- Practice address
- 1811 Health Care Dr
Trinity, FL 34655-5363 - Phone
- (727) 376-9611
- Fax
- (727) 376-0752
- NPI assigned
- Jan 30, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Todd Bodanza, D.C.
- Title
- Doctor
- Phone
- (727) 376-9611
Practitioners 1
-
Todd J Bodanza, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050917000234 | FL | Part B Supplier - Clinic/Group Practice | 0143253336 |
Receives reassigned benefits from 1 practitioner Practice locations: Trinity, FL |
National Provider Directory
Locations
1811 Health Care Dr
Trinity, FL 34655
Phone (727) 376-9611
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | CH7068 | FL | Yes |
Addresses
Primary practice location
1811 Health Care Dr
Trinity, FL 34655-5363
Mailing address
1811 Health Care Dr
Trinity, FL 34655-5363
Phone (727) 376-9611
Other providers in Trinity, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.