Provider Demographics
NPI:1104787373
Name:HEALTHSOURCE OF VALRICO LLC
Entity type:Organization
Organization Name:HEALTHSOURCE OF VALRICO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUNO
Authorized Official - Middle Name:
Authorized Official - Last Name:CONTRO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-937-4862
Mailing Address - Street 1:11305 NW 55TH LN
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3816
Mailing Address - Country:US
Mailing Address - Phone:610-937-4862
Mailing Address - Fax:
Practice Address - Street 1:1995 E STATE ROAD 60
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-3604
Practice Address - Country:US
Practice Address - Phone:813-598-5409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-18
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty