Provider Demographics
NPI:1033520366
Name:MINAYA, FREDDY ELISA (DC)
Entity type:Individual
Prefix:DR
First Name:FREDDY
Middle Name:ELISA
Last Name:MINAYA
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 1:2451 N MCMULLEN BOOTH RD
Mailing Address - Street 2:SUITE 226
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1356
Mailing Address - Country:US
Mailing Address - Phone:863-651-2012
Mailing Address - Fax:727-725-0389
Practice Address - Street 1:2451 N MCMULLEN BOOTH RD
Practice Address - Street 2:SUITE 226
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1356
Practice Address - Country:US
Practice Address - Phone:863-651-2012
Practice Address - Fax:727-725-0389
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11127111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor