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General NPI Number Information
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NPI Number | 1710259247
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Entity Type | Organization
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Legal Business Name | CHIROMEDIC SERVICES OF N.M.B, INC
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Dates
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Enumeration Date | 01/30/2012
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 16932 NE 19TH AVE
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-3110
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Country | US
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Telephone | 786-201-2778
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Fax |
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Provider Business Mailing Address
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Address Line | 16932 NE 19TH AVE
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-3110
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Country | US
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Telephone | 786-201-2778
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. PAUL L GUADAGNO
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Credential | DC
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Telephone | 786-657-3242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | CH9004
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License Number State | FL
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