Provider Demographics
NPI:1649293507
Name:JAMES A DECUBELLIS DC
Entity type:Organization
Organization Name:JAMES A DECUBELLIS DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:DECUBELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-841-8488
Mailing Address - Street 1:8614 LITTLE ROAD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654
Mailing Address - Country:US
Mailing Address - Phone:727-841-8488
Mailing Address - Fax:727-848-5227
Practice Address - Street 1:8614 LITTLE ROAD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654
Practice Address - Country:US
Practice Address - Phone:727-841-8488
Practice Address - Fax:727-848-5227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381646000Medicaid
FL381646000Medicaid