MEDICARE: DR. TIMOTHY PERENICH 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	CH11135	FL

General Provider Information

NPI Number	:	1265891592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY PERENICH DC

Provider Business Mailing Address
First Line	:	1320 GULFVIEW WOODS LN
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689-2930
Country	:	US
Telephone Number	:	727-937-7245
Fax Number	:

Provider Business Practice Location Address
First Line	:	35008 US HIGHWAY 19 N
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-1925
Country	:	US
Telephone Number	:	727-784-6900
Fax Number	:

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

Provider Enumeration Date	:	02/15/2016
Last Update Date	:	02/15/2016

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Directions to “ DR. TIMOTHY PERENICH DC” Practice Location

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