Provider Demographics
NPI:1386762730
Name:ARVANITIS, DOUG HARRY (DC)
Entity type:Individual
Prefix:DR
First Name:DOUG
Middle Name:HARRY
Last Name:ARVANITIS
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 1:936 S HOWARD AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2421
Mailing Address - Country:US
Mailing Address - Phone:813-251-2052
Mailing Address - Fax:813-251-9681
Practice Address - Street 1:936 S HOWARD AVE
Practice Address - Street 2:SUITE D
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2421
Practice Address - Country:US
Practice Address - Phone:813-251-2052
Practice Address - Fax:813-251-9681
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7428111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU74482Medicare UPIN