Individual provider Active NPI

Adolfo Peraza, DC

  • Chiropractor
  • Lakeland, FL
National Provider Identifier
1750118360
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH15150 Issued in FL
Practice address
1509 S Florida Ave Ste 3
Lakeland, FL 33803-2258
Phone
(863) 616-1370
NPI assigned
Sep 17, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH15150 FL Primary

Addresses

Primary practice location

1509 S Florida Ave Ste 3
Lakeland, FL 33803-2258

Mailing address

6829 Bushnell Dr
Lakeland, FL 33813-3738
Phone (863) 430-4341

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
CH15150FLMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1750118360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6829 BUSHNELL DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338133738",
            "telephone_number": "863-430-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 S FLORIDA AVE STE 3",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338032258",
            "telephone_number": "863-616-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERAZA",
        "first_name": "ADOLFO",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH15150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.