Provider Demographics
NPI:1700779501
Name:LEGACY MEDICAL ASSOCIATES INCORPORATED
Entity type:Organization
Organization Name:LEGACY MEDICAL ASSOCIATES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:KASEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-290-5681
Mailing Address - Street 1:5633 E LEITNER DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2048
Mailing Address - Country:US
Mailing Address - Phone:319-290-5681
Mailing Address - Fax:
Practice Address - Street 1:3001 CORAL HILLS DR STE 170
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4172
Practice Address - Country:US
Practice Address - Phone:319-290-5681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty