Individual provider Active NPI

Corie Mendizabal

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1568235752
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH14703 Issued in FL
Practice address
3450 E Fletcher Ave Ste 320
Tampa, FL 33613-4659
Phone
(813) 668-0000
NPI assigned
Oct 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH14703 FL Primary

Addresses

Primary practice location

3450 E Fletcher Ave Ste 320
Tampa, FL 33613-4659

Mailing address

9914 Jackfruit CT
Riverview, FL 33578-3312

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
CH14703FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Physical Medicine of North Tampa LLC Chiropractor CurrentSince Nov 5, 2023 Accepting new patients

Locations

3450 E Fletcher Ave
Ste 320
Tampa, FL 33613
Phone (813) 668-0000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1568235752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9914 JACKFRUIT CT",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335783312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 E FLETCHER AVE STE 320",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134659",
            "telephone_number": "813-668-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIZABAL",
        "first_name": "CORIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.