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General NPI Number Information
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NPI Number | 1861802530
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Entity Type | Individual
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Provider Name | MICHAEL LAURENS MASUCCI D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 1701 MILITARY TRL STE 145B
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City | JUPITER
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State | FL
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Zip | 33458-6330
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Country | US
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Telephone | 561-781-0989
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Fax | 561-781-0947
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Provider Business Mailing Address
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Address Line | 110 PALOMINO DR
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City | JUPITER
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State | FL
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Zip | 33458-8009
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Country | US
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Telephone | 314-630-8991
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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 | 2014013287
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License Number State | MO
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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 | CH12555
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License Number State | FL
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