Provider Demographics
NPI:1285334565
Name:SAMBURSKY, RACHEL (DC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SAMBURSKY
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 1:9907 SIR FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33637-4912
Mailing Address - Country:US
Mailing Address - Phone:727-300-9660
Mailing Address - Fax:
Practice Address - Street 1:2719 1ST AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8723
Practice Address - Country:US
Practice Address - Phone:727-300-9660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14117111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH14117OtherCHIROPRACTIC PHYSICIAN LICENSE