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NPI Code Detail

MEDICARE: DR. BLAISE MITCHELL DELMONACHE D.C.

MEDICARE:  DR. BLAISE MITCHELL DELMONACHE  D.C.
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
1111N00000XChiropractorCH7555FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043319460
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BLAISE MITCHELL DELMONACHE D.C.
Provider Business Mailing Address
First Line : 3413 S KINGS AVE
Second Line : SUITE 100
City : BRANDON
State : FL
Zip : 33511-7780
Country : US
Telephone Number : 813-684-8489
Fax Number :
Provider Business Practice Location Address
First Line : 3413 S KINGS AVE
Second Line : SUITE 100
City : BRANDON
State : FL
Zip : 33511-7780
Country : US
Telephone Number : 813-684-8489
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 06/03/2011

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Directions to “ DR. BLAISE MITCHELL DELMONACHE D.C.” Practice Location

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