MEDICARE: DR. PAUL PHILIP FARRUGGIO 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	X011687	OK
2	111NN1001X	Nutrition Chiropractor	X011687	FL

General Provider Information

NPI Number	:	1841621208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL PHILIP FARRUGGIO D.C.

Provider Business Mailing Address
First Line	:	2051 OAK MEADOW CIR
Second Line	:
City	:	SOUTH DAYTONA
State	:	FL
Zip	:	32119-8822
Country	:	US
Telephone Number	:	917-797-0960
Fax Number	:	386-275-1956

Provider Business Practice Location Address
First Line	:	2137 S RIDGEWOOD AVE
Second Line	:
City	:	SOUTH DAYTONA
State	:	FL
Zip	:	32119-3015
Country	:	US
Telephone Number	:	386-275-1956
Fax Number	:	386-275-1956

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

Provider Enumeration Date	:	12/10/2013
Last Update Date	:	03/19/2018

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