MEDICARE: MR. MICHAEL ROSS MYERS D.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH 8920	FL

General Provider Information

NPI Number	:	1013131788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL ROSS MYERS D.C

Provider Business Mailing Address
First Line	:	450 N PARK RD
Second Line	:	SUITE 200
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6917
Country	:	US
Telephone Number	:	954-986-4559
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 N PARK RD
Second Line	:	SUITE 200
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6917
Country	:	US
Telephone Number	:	954-986-4559
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	04/26/2018

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