MEDICARE: INFINITY HEALTH SYSTEMS INC

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	CH7883	FL

General Provider Information

NPI Number	:	1114176542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITY HEALTH SYSTEMS INC

Provider Business Mailing Address
First Line	:	PO BOX 17809
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32245-7809
Country	:	US
Telephone Number	:	904-723-5665
Fax Number	:	904-338-0951

Provider Business Practice Location Address
First Line	:	1361 13TH AVE S STE 160
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-3235
Country	:	US
Telephone Number	:	904-339-0555
Fax Number	:	904-399-0554

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DONALD LOWERY
Credential	:	DC
Telephone Number	:	904-339-0555

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	09/10/2008

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