Provider Demographics
NPI:1144542812
Name:KORY CASEY, P.A.
Entity type:Organization
Organization Name:KORY CASEY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:321-676-5600
Mailing Address - Street 1:15 E. HIBISCUS BLVD.
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901
Mailing Address - Country:US
Mailing Address - Phone:321-676-5600
Mailing Address - Fax:321-951-8162
Practice Address - Street 1:551 S APOLLO BLVD
Practice Address - Street 2:205
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1274
Practice Address - Country:US
Practice Address - Phone:321-676-5600
Practice Address - Fax:321-951-8162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003336111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380307400Medicaid
FL88465Medicare UPIN