| Jayne Kwiatkowski Llc | |
|
1414 W Granada Blvd Ste 3 Ormond Beach FL 32174-8104 | |
| (386) 872-5323 | |
| Not Available |
| Full Name | Jayne Kwiatkowski Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1414 W Granada Blvd Ste 3, Ormond Beach, Florida |
| Authorized Official Name and Position | Jayne Kwiatkowski (OWNER/MGR) |
| Authorized Official Contact | 3868725323 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jayne Kwiatkowski Llc 1414 W Granada Blvd Ste 3 Ormond Beach FL 32174-8104 Ph: (386) 872-5323 | Jayne Kwiatkowski Llc 1414 W Granada Blvd Ste 3 Ormond Beach FL 32174-8104 Ph: (386) 872-5323 |
| NPI Number | 1427466051 |
|---|---|
| Provider Enumeration Date | 07/28/2014 |
| Last Update Date | 02/26/2020 |
| Medicare PECOS PAC ID | 1658700935 |
|---|---|
| Medicare Enrollment ID | O20200408000644 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427466051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | CH9417 (Florida) | Primary |
| Provider Name | Jayne Marie Kwiatkowski |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1588850218 PECOS PAC ID: 5496839219 Enrollment ID: I20080303000509 |
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