Healthcare Provider Details

I. General information

NPI: 1871507152
Provider Name (Legal Business Name): ERNEST S. CARUSO, DC, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 01/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 NW BOCA RATON BLVD SUITE A24
BOCA RATON FL
33431-6657
US

IV. Provider business mailing address

3350 NW BOCA RATON BLVD SUITE A24
BOCA RATON FL
33431-6657
US

V. Phone/Fax

Practice location:
  • Phone: 561-447-2228
  • Fax: 561-447-2230
Mailing address:
  • Phone: 561-447-2228
  • Fax: 561-447-2230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH7975
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT21879
License Number StateFL

VIII. Authorized Official

Name: LAURA B BURKE JR.
Title or Position: MCC
Credential: MCC
Phone: 954-563-4472