MEDICARE: THOMAS HYDE 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	CH 2719	FL

General Provider Information

NPI Number	:	1861615072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS HYDE D.C

Provider Business Mailing Address
First Line	:	2440 NE MIAMI GARDENS DRIVE
Second Line	:	SUITE #101
City	:	AVENTURA
State	:	FL
Zip	:	33180
Country	:	US
Telephone Number	:	305-705-0777
Fax Number	:	305-705-9978

Provider Business Practice Location Address
First Line	:	2440 NE MIAMI GARDENS DRIVE
Second Line	:	SUITE #101
City	:	AVENTURA
State	:	FL
Zip	:	33180
Country	:	US
Telephone Number	:	305-705-0777
Fax Number	:	305-705-9978

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

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	07/08/2007

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