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General NPI Number Information
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NPI Number | 1669864005
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Entity Type | Organization
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Legal Business Name | JOSEPH FISCHETTI, PA
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Dates
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Enumeration Date | 02/23/2015
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Last Update Date | 02/23/2015
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Provider Practice Location Address
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Address Line | 2755 W ATLANTIC BLVD SUITE 103
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City | POMPANO BEACH
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State | FL
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Zip | 33069-2625
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Country | US
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Telephone | 754-220-8781
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Fax | 754-220-8782
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Provider Business Mailing Address
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Address Line | 2755 W ATLANTIC BLVD SUITE 103
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City | POMPANO BEACH
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State | FL
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Zip | 33069-2625
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Country | US
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Telephone | 754-220-8781
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Fax | 754-220-8782
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. JOSEPH FISCHETTI
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Credential | DC
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Telephone | 754-220-8781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number | ME83875
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH10272
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License Number State | FL
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