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General NPI Number Information
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NPI Number | 1447784111
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Entity Type | Individual
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Provider Name | MADELINE MARIE MO'HYLA D.C.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2017
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 777 S PALM AVE UNIT 8
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City | SARASOTA
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State | FL
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Zip | 34236-7746
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Country | US
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Telephone | 941-400-1028
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Fax |
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Provider Business Mailing Address
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Address Line | 2857 BAY ST
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City | SARASOTA
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State | FL
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Zip | 34237-8631
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Country | US
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Telephone | 941-315-3715
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CH12010
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License Number State | FL
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