MEDICARE: DR. MANUEL FARIA DC NMD MD DIPL AC

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	CH4434	FL

General Provider Information

NPI Number	:	1073693933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANUEL FARIA DC NMD MD DIPL AC

Provider Business Mailing Address
First Line	:	195 S WESTMONTE DRIVE
Second Line	:	SUITE 1116
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-4219
Country	:	US
Telephone Number	:	407-862-2287
Fax Number	:	407-869-5433

Provider Business Practice Location Address
First Line	:	195 S WESTMONTE DRIVE
Second Line	:	SUITE 1116
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-4219
Country	:	US
Telephone Number	:	407-862-2287
Fax Number	:	407-869-5433

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	07/30/2012

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