Provider Demographics
NPI:1285757369
Name:PASCO ALTERNATIVE HEALTHCARE
Entity type:Organization
Organization Name:PASCO ALTERNATIVE HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CLAMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-973-0300
Mailing Address - Street 1:2216 US HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34691-4351
Mailing Address - Country:US
Mailing Address - Phone:727-943-0300
Mailing Address - Fax:727-943-0339
Practice Address - Street 1:2216 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-4351
Practice Address - Country:US
Practice Address - Phone:727-943-0300
Practice Address - Fax:727-943-0339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8475111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94860OtherBLUE CROSS GRP
FL70109ZMedicare ID - Type UnspecifiedPASCO ALT HEATLHCARE
FL94860OtherBLUE CROSS GRP
FL70109AMedicare ID - Type UnspecifiedTODD SWEENEY DC