Provider Demographics
NPI:1649279068
Name:BIRKS, LAUREN (DC)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:BIRKS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3034 UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2502
Mailing Address - Country:US
Mailing Address - Phone:941-360-2428
Mailing Address - Fax:941-360-2418
Practice Address - Street 1:3034 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2502
Practice Address - Country:US
Practice Address - Phone:941-360-2428
Practice Address - Fax:941-360-2418
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8302111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV05312Medicare UPIN
FLK7763Medicare ID - Type UnspecifiedGROUP NUMBER
FLU4912AMedicare ID - Type UnspecifiedPROVIDER NUMBER