Healthcare Provider Details

I. General information

NPI: 1922542000
Provider Name (Legal Business Name): RICHARD PAUL MINUSKI JR. D.C., APRN, AGNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2016
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 S BABCOCK ST
MELBOURNE FL
32901-4445
US

IV. Provider business mailing address

1920 S BABCOCK ST
MELBOURNE FL
32901-4445
US

V. Phone/Fax

Practice location:
  • Phone: 201-350-4909
  • Fax: 321-256-6849
Mailing address:
  • Phone: 201-350-4909
  • Fax: 321-256-6849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11049074
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number012893
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00740300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: