MEDICARE: DR. RYAN EMMANUEL SPICUZZO 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	CH10306	FL

General Provider Information

NPI Number	:	1548564982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN EMMANUEL SPICUZZO DC

Provider Business Mailing Address
First Line	:	2125 PARK PL
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33486-3132
Country	:	US
Telephone Number	:	561-797-5132
Fax Number	:	954-697-0497

Provider Business Practice Location Address
First Line	:	100 S MILITARY TRL STE 33
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-3032
Country	:	US
Telephone Number	:	954-570-4080
Fax Number	:	954-697-0497

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

Provider Enumeration Date	:	12/28/2010
Last Update Date	:	10/09/2023

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