MEDICARE: DR. CHRISTOPHER A DICARLO DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH7202	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	55483	OTHER	FL	BCBS OF FL
2	8464021	OTHER	FL	CIGNA

General Provider Information

NPI Number	:	1033228721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER A DICARLO DC

Provider Business Mailing Address
First Line	:	2415 HOLLYWOOD BLVD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-6605
Country	:	US
Telephone Number	:	954-456-0250
Fax Number	:	954-456-0820

Provider Business Practice Location Address
First Line	:	2415 HOLLYWOOD BLVD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-6605
Country	:	US
Telephone Number	:	954-456-0250
Fax Number	:	954-456-0820

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	09/19/2016

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Directions to “ DR. CHRISTOPHER A DICARLO DC” Practice Location

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