Alexis G Aqui, D.C.

Individual provider Active NPI Chiropractor · Bartow, FL

NPI 1649245481 · NPPES record last updated Aug 21, 2012

Key facts

NPI
1649245481
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
CH7980 (FL)
Practice address
1350 E Main Street
Suite B1
Bartow, FL 33830
Phone
(863) 534-3288
Fax
(863) 534-3436
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Chiropractic
Education
National College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1350 E Main St
B 1
Bartow, FL 33830-5064
Phone (863) 534-3288

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20070621000403 FL Practitioner - Chiropractic 1052410701 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
CH7980FLMDChiropractor
7980FLMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Aqui Chiropractic Clinic LLC Chiropractor Current
since May 17, 2006
Accepting new patients
Community Rehab & Wellness Inc Past
since May 17, 2006
Accepting new patients

Locations

1350 E Main St
Ste B-4
Bartow, FL 33830
Phone (863) 534-3288

1350 E Main St
Ste B-1
Bartow, FL 33830
Phone (863) 534-3288

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7980 FL Yes

Addresses

Primary practice location

1350 E Main Street
Suite B1
Bartow, FL 33830

Mailing address

1350 E Main Street
Suite B-1
Bartow, FL 33830
Phone (863) 534-3288

Other providers in Bartow, FL

All providers in Bartow, FL · Chiropractor in Florida

Sources for this page

Verify at the official NPI Registry.