MEDICARE: DR. LAURA MOCH VALHUERDI DC

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	CHIR008243	GA
2	111N00000X	Chiropractor	CH9508	FL

General Provider Information

NPI Number	:	1124204458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA MOCH VALHUERDI DC

Provider Business Mailing Address
First Line	:	210 N BROUGHTON SQ
Second Line	:	BUILDING 7
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-2547
Country	:	US
Telephone Number	:	561-374-2451
Fax Number	:

Provider Business Practice Location Address
First Line	:	3379 W WOOLBRIGHT RD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-7245
Country	:	US
Telephone Number	:	561-374-2451
Fax Number	:

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

Provider Enumeration Date	:	01/16/2008
Last Update Date	:	07/31/2008

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