Individual
DR. JOHN RAMON BANACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2429 ALT 19, PALM HARBOR, FL 34683-2633
(727) 786-8991
Mailing address
2429 ALT 19, PALM HARBOR, FL 34683-2633
(727) 786-8991
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
Primary
CH4858
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74889
MEDICARE GROUP ID #
FL
Enumeration date
03/01/2006
Last updated
10/24/2007
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