Provider Demographics
NPI:1366536633
Name:NAPLES CHIROPRACTIC CENTER, INC.
Entity type:Organization
Organization Name:NAPLES CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOMAYOUN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIDABADI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-596-1601
Mailing Address - Street 1:1890 SW HEALTH PKWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0473
Mailing Address - Country:US
Mailing Address - Phone:239-596-1601
Mailing Address - Fax:239-596-9622
Practice Address - Street 1:1890 SW HEALTH PKWY
Practice Address - Street 2:SUITE 204
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0473
Practice Address - Country:US
Practice Address - Phone:239-596-1601
Practice Address - Fax:239-596-9622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
55623Medicare ID - Type Unspecified
U70194Medicare UPIN