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Dr. Wanda Ivelisse Nieves-moreno, DC
Chiropractor in Brandon, Florida
NPI 1891780037

Wanda Ivelisse Nieves-moreno is a Chiropractor based in Brandon, FL. Wanda Ivelisse Nieves-moreno practices in Brandon, FL and has the professional credentials of DC. The NPI Number for Wanda Ivelisse Nieves-moreno is 1891780037 and holds a License No. CH8811 (Florida).

The current practice location address for Wanda Ivelisse Nieves-moreno is 654 E Bloomingdale Ave, Brandon, FL and can be reached out via phone at 813-685-5200 and via fax at 813-654-8758.

Location: 654 E Bloomingdale Ave, Brandon, FL, 33511-8111
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1891780037
Provider Name
Wanda Ivelisse Nieves-moreno
Credential
DC
Provider Entity Type
Individual
Gender
Female
Address
654 E Bloomingdale Ave, Brandon, FL, 33511-8111
Phone Number
813-685-5200
Fax Number
813-654-8758
Provider Enumeration Date
09/14/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
381946900 05 FL
U6011Z 01 FL MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
654 E Bloomingdale Ave
City
Brandon
State
Florida
Zip
33511-8111
Phone Number
813-685-5200
Fax Number
813-654-8758
person
Provider Business Mailing Address Details
Address
654 E Bloomingdale Ave
City
Brandon
State
Florida
Zip
33511-8111
Phone Number
813-685-5200
Fax Number
813-654-8758
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
CH8811 (Florida)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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