Healthcare Provider Details

I. General information

NPI: 1699772418
Provider Name (Legal Business Name): NATHALIE M DIGIORGIO DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 02/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 NE 24TH AVE SUITE 100
POMPANO BEACH FL
33062-5206
US

IV. Provider business mailing address

24 NE 24TH AVE SUITE 100
POMPANO BEACH FL
33062-5206
US

V. Phone/Fax

Practice location:
  • Phone: 866-632-4476
  • Fax: 954-943-7708
Mailing address:
  • Phone: 866-632-4476
  • Fax: 954-943-7708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH8071
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: