MEDICARE: DR. CARL G CONFORTI 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
1	111N00000X	Chiropractor	CH7630	FL

General Provider Information

NPI Number	:	1558432492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARL G CONFORTI D.C.

Provider Business Mailing Address
First Line	:	146 CARLYLE DR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-1807
Country	:	US
Telephone Number	:	813-818-7499
Fax Number	:

Provider Business Practice Location Address
First Line	:	4040 TAMPA RD
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-3205
Country	:	US
Telephone Number	:	813-818-7499
Fax Number	:	813-818-7239

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	12/18/2012

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