1497486492 NPI number — NEXT LEVEL FAMILY CHIROPRACTIC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497486492 NPI number — NEXT LEVEL FAMILY CHIROPRACTIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEXT LEVEL FAMILY CHIROPRACTIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497486492
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3100 US 1 S STE 4A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT AUGUSTINE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32086-6310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-429-7019
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3100 US 1 S STE 4A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT AUGUSTINE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32086-6310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-429-7019
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/21/2022

Additional Information

Authorized Official

Authorized Official Last Name:
VELIJOSKI
Authorized Official First Name:
MARGRET
Authorized Official Middle Name:
Authorized Official Title or Position:
CO-OWNER/CHIROPRACTOR
Authorized Official Telephone Number:
904-429-7019

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1225777436 . This is a "NPI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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