Organization Active NPI

Raymond D. Clites D.C., P.a.

  • Chiropractor
  • Brandon, FL
National Provider Identifier
1790931277
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0004571 Issued in FL
Legal business name
RAYMOND D. CLITES D.C., P.A.
Practice address
134 N Moon Ave
Brandon, FL 33510-4420
Phone
(813) 684-1648
Fax
(813) 684-1748
NPI assigned
Aug 15, 2008
Last updated
Jan 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

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

Authorized official

Name
Dr. Raymond Dale Clites, D.C.NPI 1942275623
Title
Doctor/Owner
Phone
(813) 684-1648

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0004571 FL Primary

Addresses

Primary practice location

134 N Moon Ave
Brandon, FL 33510-4420

Mailing address

134 N Moon Ave
Brandon, FL 33510-4420
Phone (813) 684-1648

Other identifiers 1

IdentifierTypeStateIssuer
380271000MedicaidFL

National Provider Directory

National Provider Directory

Locations

2119 W Brandon Blvd
Ste M
Brandon, FL 33511
Phone (813) 684-1648

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390780800000",
    "number": "1790931277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 N MOON AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104420",
            "telephone_number": "813-684-1648",
            "fax_number": "813-684-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 N MOON AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104420",
            "telephone_number": "813-684-1648",
            "fax_number": "813-684-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND D. CLITES D.C., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-15",
        "last_updated": "2014-01-27",
        "status": "A",
        "authorized_official_last_name": "CLITES",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "813-684-1648",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0004571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380271000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.