Redefine Your Spine Llc | |
11012 N Dale Mabry Hwy Ste 304, Tampa, FL 33618-3821 | |
(813) 563-7600 | |
(813) 563-7601 |
Full Name | Redefine Your Spine Llc |
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Type | Facility |
Speciality | Chiropractor |
Location | 11012 N Dale Mabry Hwy Ste 304, Tampa, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174250070 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Primary |
Provider Name | Jacob Goldberg |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1043716459 PECOS PAC ID: 5496121493 Enrollment ID: I20221017001399 |
Mailing Address | Practice Location Address |
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Redefine Your Spine Llc 11012 N Dale Mabry Hwy Ste 304, Tampa, FL 33618-3821 Ph: (813) 563-7600 | Redefine Your Spine Llc 11012 N Dale Mabry Hwy Ste 304, Tampa, FL 33618-3821 Ph: (813) 563-7600 |
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