Basic Information
| Provider Information | |||||||||
| NPI: | 1477581445 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAPA | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2755 | ||||||||
| Address2: | |||||||||
| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334682755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617447373 | ||||||||
| FaxNumber: | 5617431192 | ||||||||
| Practice Location | |||||||||
| Address1: | 2632 W INDIANTOWN RD | ||||||||
| Address2: | |||||||||
| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334585889 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617447373 | ||||||||
| FaxNumber: | 5617431192 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2006 | ||||||||
| LastUpdateDate: | 08/11/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | CH0005978 | FL | Y | Chiropractic Providers | Chiropractor |
ID Information
| ID | Type | State | Issuer | Description | 380561100 | 05 | FL | MEDICAID | 5897437 | 01 | FL | GHI | OTHER | 221184 | 01 | FL | AVMED | OTHER | P00115299 | 01 | FL | RAILROAD MEDICARE | OTHER | 22383 | 01 | FL | BLUE CROSS BLUE SHIELD | OTHER |