Provider Demographics
NPI:1285069310
Name:ZIMMERMAN, ADAM (DC)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 S SHORE DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32550-5821
Mailing Address - Country:US
Mailing Address - Phone:850-312-1456
Mailing Address - Fax:888-977-1639
Practice Address - Street 1:30 S SHORE DR
Practice Address - Street 2:
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-5821
Practice Address - Country:US
Practice Address - Phone:850-312-1456
Practice Address - Fax:888-977-1639
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2023-12-05
Deactivation Date:2022-12-13
Deactivation Code:
Reactivation Date:2023-12-05
Provider Licenses
StateLicense IDTaxonomies
GACHIR009189111NS0005X
FLCH11737111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician