NPIMap

Organization Active NPI

Florida Professional Chiropractic

  • Chiropractor
  • Lake Wales, FL
National Provider Identifier
1891004065
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6181 Issued in FL
Legal business name
FLORIDA PROFESSIONAL CHIROPRACTIC
Practice address
100 S Scenic Hwy
Suite 105
Lake Wales, FL 33853-3827
Phone
(863) 676-2225
Fax
(863) 676-0698
NPI assigned
Oct 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Authorized official

Name
Mrs. Kellie Anne FaroNPI 1033356985
Title
Vice President
Phone
(863) 676-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH6181 FL Primary

Addresses

Primary practice location

100 S Scenic Hwy
Suite 105
Lake Wales, FL 33853-3827

Mailing address

100 S Scenic Hwy
Suite 105
Lake Wales, FL 33853-3827
Phone (863) 676-2225

National Provider Directory

National Provider Directory

Locations

100 S Scenic Hwy
Ste 105
Lake Wales, FL 33853
Phone (863) 676-2225

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307318400000",
    "number": "1891004065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S SCENIC HWY",
            "address_2": "SUITE 105",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338533827",
            "telephone_number": "863-676-2225",
            "fax_number": "863-676-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S SCENIC HWY",
            "address_2": "SUITE 105",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338533827",
            "telephone_number": "863-676-2225",
            "fax_number": "863-676-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PROFESSIONAL CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2011-06-06",
        "status": "A",
        "authorized_official_last_name": "FARO",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "863-676-2225",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.