Organization
COCOA CHIROPRACTIC CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW R CANAVAN DC (PRESIDENT)
(321) 636-6090
Entity
Organization
Contact information
Practice address
111 N FISKE BLVD, COCOA, FL 32922-7211
(321) 636-6090
(321) 632-5805
Mailing address
111 N FISKE BLVD, COCOA, FL 32922-7211
(321) 636-6090
(321) 632-5805
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093051815
CHIROPRACTOR
FL
01
—
1639143118
CHIROPRACTOR
FL
Enumeration date
02/04/2019
Last updated
08/16/2023
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