Provider Demographics
NPI:1871617878
Name:VILFORT, CARLINE M (DC)
Entity type:Individual
Prefix:DR
First Name:CARLINE
Middle Name:M
Last Name:VILFORT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6328 US HIGHWAY 301 S
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-3829
Mailing Address - Country:US
Mailing Address - Phone:813-443-5868
Mailing Address - Fax:813-443-5869
Practice Address - Street 1:6328 US HIGHWAY 301 S
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-3829
Practice Address - Country:US
Practice Address - Phone:813-443-5868
Practice Address - Fax:813-443-5869
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10006111N00000X
FLCH8545111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3138997OtherAETNA
NYX6T561Medicare ID - Type Unspecified
NY3138997OtherAETNA