=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265608541
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHARNI & FICO CHIROPRACTORS PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/06/2008
-----------------------------------------------------
Last Update Date | 05/06/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10167 NW 31ST ST SUITE 100
-----------------------------------------------------
City | CORAL SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33065-6152
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-341-9988
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10167 NW 31ST ST SUITE 100
-----------------------------------------------------
City | CORAL SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33065-6152
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-341-9988
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SECRETARY/TREASURER
-----------------------------------------------------
Name | DR. ANDREW JOHN CHARNI
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 954-341-9988
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH5232
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------