MEDICARE: DR. BRYAN T HUNTE 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	CH11436	FL
2	111NS0005X	Sports Physician Chiropractor	038009628	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K21386	OTHER	IL	PIN

General Provider Information

NPI Number	:	1144381948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYAN T HUNTE D.C.

Provider Business Mailing Address
First Line	:	16517 VANDERBILT DR STE 3
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-7550
Country	:	US
Telephone Number	:	773-636-3824
Fax Number	:

Provider Business Practice Location Address
First Line	:	16517 VANDERBILT DR STE 3
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-7550
Country	:	US
Telephone Number	:	773-636-3824
Fax Number	:

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	09/24/2019

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