=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669692927
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CATERINA SIRENA CAMPESI D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/27/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5675 CORAL RIDGE DR
-----------------------------------------------------
City | CORAL SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33076-3124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-341-2256
-----------------------------------------------------
Fax | 954-341-2264
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5675 CORAL RIDGE DR
-----------------------------------------------------
City | CORAL SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33076-3124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-341-2256
-----------------------------------------------------
Fax | 954-341-2264
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH8773
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------