Provider Demographics
NPI:1386604510
Name:SMARDZ CORPORATION
Entity type:Organization
Organization Name:SMARDZ CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARBARO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-263-3369
Mailing Address - Street 1:661 GOODLETTE RD N
Mailing Address - Street 2:SUITE 108
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5609
Mailing Address - Country:US
Mailing Address - Phone:239-263-3369
Mailing Address - Fax:239-263-8842
Practice Address - Street 1:661 GOODLETTE RD N
Practice Address - Street 2:SUITE 108
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5609
Practice Address - Country:US
Practice Address - Phone:239-263-3369
Practice Address - Fax:239-263-8842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007626111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL99487OtherBLUE CROSS BLUE SHIELD
FLK2595Medicare PIN