Provider Demographics
NPI:1538349972
Name:SANDERS, DAVID ROSS (DC, DACNB)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROSS
Last Name:SANDERS
Suffix:
Gender:M
Credentials:DC, DACNB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2194 HIGHWAY A1A
Mailing Address - Street 2:SUITE 308
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4930
Mailing Address - Country:US
Mailing Address - Phone:321-777-1420
Mailing Address - Fax:321-777-9032
Practice Address - Street 1:2194 HIGHWAY A1A
Practice Address - Street 2:SUITE 308
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4930
Practice Address - Country:US
Practice Address - Phone:321-777-1420
Practice Address - Fax:321-777-9032
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7177111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55574OtherBCBS
FL55574OtherBCBS
U67125Medicare UPIN