Provider Demographics
NPI:1265225940
Name:CALEB BUNTING LLC
Entity type:Organization
Organization Name:CALEB BUNTING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNTING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:904-217-6894
Mailing Address - Street 1:13 11TH ST
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-3841
Mailing Address - Country:US
Mailing Address - Phone:615-225-7186
Mailing Address - Fax:904-788-7481
Practice Address - Street 1:2800 N 5TH ST STE 302
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-1837
Practice Address - Country:US
Practice Address - Phone:904-217-6894
Practice Address - Fax:904-788-7481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1235869520OtherNPPES
FL1871249649OtherNPPES