MEDICARE: DR. MICHAEL BRENT HUNTER 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	3352	OH
2	111N00000X	Chiropractor	CH 9572	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HQ417A	OTHER	FL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104860139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL BRENT HUNTER D.C.

Provider Business Mailing Address
First Line	:	8 PACIFIC ST
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32084-2713
Country	:	US
Telephone Number	:	904-217-8148
Fax Number	:

Provider Business Practice Location Address
First Line	:	4211 N PEARL ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32206-6411
Country	:	US
Telephone Number	:	904-358-8692
Fax Number	:

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

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	11/21/2014

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