Clearwater Spine & Rehabilitation | |
51 South Main Avenue, Suite 315, Clearwater, FL 33765-3934 | |
(727) 447-4255 | |
(727) 449-8198 |
Full Name | Clearwater Spine & Rehabilitation |
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Type | Facility |
Speciality | Nurse Practitioner |
Location | 51 South Main Avenue, Clearwater, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588915011 | NPI | - | NPPES |
382010600 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CH7755 (Florida) | Secondary |
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Provider Name | Gregory Dokka |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1952338386 PECOS PAC ID: 2961445283 Enrollment ID: I20050608000141 |
Provider Name | Lyle Robinson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487893244 PECOS PAC ID: 5496886905 Enrollment ID: I20100628000522 |
Provider Name | Theodore Ellis |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1609458223 PECOS PAC ID: 8921416181 Enrollment ID: I20210428000968 |
Provider Name | Alina Ann Colleary |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679175855 PECOS PAC ID: 4587041058 Enrollment ID: I20220523001404 |
Provider Name | William Alonzo Allen |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1689364879 PECOS PAC ID: 8921465345 Enrollment ID: I20230530003206 |
Mailing Address | Practice Location Address |
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Clearwater Spine & Rehabilitation 51 South Main Avenue, Suite 315, Clearwater, FL 33765-3934 Ph: (727) 447-4255 | Clearwater Spine & Rehabilitation 51 South Main Avenue, Suite 315, Clearwater, FL 33765-3934 Ph: (727) 447-4255 |