Provider Demographics
NPI: | 1871591529 |
---|---|
Name: | FINNIE, JAMES DOUGLAS (DC) |
Entity type: | Individual |
Prefix: | DR |
First Name: | JAMES |
Middle Name: | DOUGLAS |
Last Name: | FINNIE |
Suffix: | |
Gender: | M |
Credentials: | DC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1130 S SEMORAN BLVD |
Mailing Address - Street 2: | SUITE E |
Mailing Address - City: | ORLANDO |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32807-1457 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 407-277-3535 |
Mailing Address - Fax: | 407-277-6060 |
Practice Address - Street 1: | 1130 S SEMORAN BLVD |
Practice Address - Street 2: | SUITE E |
Practice Address - City: | ORLANDO |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32807-1457 |
Practice Address - Country: | US |
Practice Address - Phone: | 407-277-3535 |
Practice Address - Fax: | 407-277-6060 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2005-07-07 |
Last Update Date: | 2010-11-11 |
Deactivation Date: | 2006-03-21 |
Deactivation Code: | |
Reactivation Date: | 2006-03-27 |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | CH6585 | 111N00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | 76953 | Other | BLUE CROSS BLUE SHIELD ID |
FL | 4402672 | Other | UNITED HEALTHCARE PROVIDE |
FL | K3992 | Medicare ID - Type Unspecified | PROVIDER ID |
FL | U92969 | Medicare UPIN |