Provider Demographics
NPI:1386926475
Name:MIDNIGHT PASS CHIROPRACTIC, INC
Entity type:Organization
Organization Name:MIDNIGHT PASS CHIROPRACTIC, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-321-8800
Mailing Address - Street 1:4012 CORTEZ RD W
Mailing Address - Street 2:SUITE #2206
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-3109
Mailing Address - Country:US
Mailing Address - Phone:941-330-5233
Mailing Address - Fax:
Practice Address - Street 1:4012 CORTEZ RD W
Practice Address - Street 2:SUITE #2206
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3109
Practice Address - Country:US
Practice Address - Phone:941-330-5233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8486111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty