Provider Demographics
NPI:1063523066
Name:TAFEEN, AMY (DC)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:TAFEEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3529 S TUTTLE AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-6406
Mailing Address - Country:US
Mailing Address - Phone:941-924-7228
Mailing Address - Fax:
Practice Address - Street 1:3529 S TUTTLE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-6406
Practice Address - Country:US
Practice Address - Phone:941-924-7228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH003677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88734OtherBCBS
FL3385297OtherCIGNA
FL3385297OtherCIGNA
FLT95233Medicare UPIN