MICHAEL J PETTELLA, DC, PLLC (NPI# 1891013900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891013900 |
| Entity Type | Organization |
| Organization Name | MICHAEL J PETTELLA, DC, PLLC |
| Practice Address |
6175 Se 126th Ln Belleview FL 34420-5208 |
| Practice Telephone | 3522458300 |
| Mailing Telephone | 3522458300 |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2010-05-13 |
| Authorized Official Name | MICHAEL PETTELLA (PRESIDENT) |
| Authorized Official Telephone | 3522458300 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CH0006496 | FL | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAILROAD MEDICARE | 350052194 | 01 |
| Street Address |
6175 SE 126TH LN |
| City | BELLEVIEW |
| State | FL |
| Zip Code | 34420-5208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881227726 | Madison Ruth Oglesby | Behavior Technician | 10252 S Us Hwy 441 Units 3 4, Belleview, FL 34420 | 2020-02-19 |
| 1104458496 | Patricia A Jackson | Behavior Technician | 10252 S Hwy 441, Unit 3, Belleview, FL 34420 | 2020-02-05 |
| 1891251781 | Pamela M Swiss | Behavior Technician | 10252 S Hwy 441 Unit 3 and 4, Belleview, FL 34420 | 2019-02-15 |
| 1417412834 | Ashlynn Shearer | Behavior Technician | 10252 S Us Hwy 441, Units 3 & 4, Belleview, FL 34420 | 2019-02-11 |
| 1083178313 | Sheila Bush | Technician | 12791 Se 47th Ave, Belleview, FL 34420 | 2019-01-31 |
| 1124579974 | Tamara Lopez Diaz, Md. Pa | Family Medicine | 12301 Se Us Highway 441 Ste C, Belleview, FL 34420 | 2016-10-17 |
| 1780043992 | Katelyn Garrett | Registered Nurse | 11855 Se 74th Terrace, Belleview, FL 34420 | 2016-02-16 |
| 1982092458 | Tracy Mattia | Pharmacist | 11310 Se Us Hwy 301, Belleview, FL 34420 | 2015-01-06 |
| 1245666171 | Hayden Lee Durham I | Pharmacist | 10762 South Us 441, Belleview, FL 34420 | 2013-09-24 |
| 1285060608 | Cindy Marlene Merritt | Pharmacist | 10762 Se Hwy 441, Belleview, FL 34420 | 2013-09-17 |
| Find all providers in zip 34420 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609362904 | Mckenney Chiropractic Center Pa | Chiropractor | 5608 Se 113th St Ste A, Belleview, FL 34420-4069 | 2018-07-10 |
| 1487959409 | Ryan Michael Stewart | Chiropractor | 5608 Se 113th Street Suite A, Belleview, FL 34420 | 2011-01-23 |
| 1780895268 | James N Scott | Chiropractor | 11203 Se 53rd Ct, Belleview, FL 34420-2502 | 2007-05-25 |
| 1942354360 | Belleview Chiropractic Clinic Pa | Chiropractor | 11730 Se Us Highway 441, Belleview, FL 34420-4560 | 2007-01-23 |
| 1306867908 | Chris W Mckenney | Chiropractor | 5608 Se 113th St, Suite A, Belleview, FL 34420-4038 | 2006-07-21 |
| 1043200140 | Michael J Pettella | Chiropractor | 6175 S.e. 126th Lane, Belleview, FL 34420-5208 | 2005-10-28 |
| 1598251712 | Brandon Robert Taylor | Chiropractor | 5608 Se 113th St Ste A, Belleview, FL 34420-4069 | 2018-07-11 |
| 1982988382 | One Life Chiropractic, Pa | Chiropractor | 11203 Se 53rd Ct, Belleview, FL 34420-2502 | 2011-10-04 |
| 1972826832 | Brittney M Stewart | Chiropractor | 5608 Se 113th St, Ste A, Belleview, FL 34420-4069 | 2010-03-08 |
| 1639380140 | Dennis R Seese | Chiropractor | 11730 Se Us Highway 441, Belleview, FL 34420-4560 | 2007-05-25 |
| Find all providers in BELLEVIEW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.