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Individual

CARL JOHN ABENDROTH III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
2100 SE OCEAN BLVD, SUITE 101, STUART, FL 34996-3332
(772) 223-7337
(772) 223-0305
Mailing address
2100 SE OCEAN BLVD, SUITE 101, STUART, FL 34996-3332
(772) 223-7337
(772) 223-0305

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH7777
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
55897
BCBS PROVIDER ID
FL
01
650951021
TAX ID
FL
01
CH7777
STATE LICENSE
FL
Enumeration date
12/06/2006
Last updated
06/13/2008
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