Provider Demographics
NPI:1386617645
Name:SKARO, DAVID VICE (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:VICE
Last Name:SKARO
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 1:4994 PARK BLVD N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3409
Mailing Address - Country:US
Mailing Address - Phone:727-466-3333
Mailing Address - Fax:773-275-1568
Practice Address - Street 1:4994 PARK BLVD N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3409
Practice Address - Country:US
Practice Address - Phone:727-466-3333
Practice Address - Fax:773-275-1568
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10684111N00000X, 111N00000X, 111NN1001X, 111NR0400X, 111NX0800X, 111N00000X
MI2301008129111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1386617645OtherNPI
IL01635608OtherBCBS PROVIDER ID NO.
ILV07219Medicare UPIN
IL212570Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID NO.
IL01635608OtherBCBS PROVIDER ID NO.