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General NPI Number Information
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NPI Number | 1154500924
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Entity Type | Organization
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Legal Business Name | MARANDINO SCHARGEN CHIROPRACTIC, P.A.
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 301 KENILWORTH AVE SUITE A
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City | ORMOND BEACH
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State | FL
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Zip | 32174-4545
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Country | US
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Telephone | 386-673-2424
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Fax | 386-673-8222
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Provider Business Mailing Address
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Address Line | 301 KENILWORTH AVE SUITE A
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City | ORMOND BEACH
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State | FL
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Zip | 32174-4545
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Country | US
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Telephone | 386-673-2424
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Fax | 386-673-8222
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Authorized Official
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Title or Position | CO-OWNER
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Name | MARCIE MARANDINO
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Credential | D.C.
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Telephone | 386-673-2424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH8509
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License Number State | FL
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