Provider Demographics
NPI:1962618157
Name:NALDA FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:NALDA FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:G
Authorized Official - Last Name:NALDA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-957-1337
Mailing Address - Street 1:PO BOX 700116
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34770-0116
Mailing Address - Country:US
Mailing Address - Phone:407-957-1337
Mailing Address - Fax:407-957-1848
Practice Address - Street 1:4041 13TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-6772
Practice Address - Country:US
Practice Address - Phone:407-957-1337
Practice Address - Fax:407-957-1848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55655OtherBCBS
FL55655OtherBCBS
FL55655OtherBCBS