MEDICARE: DR. PAUL L GUADAGNO 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	111NR0400X	Rehabilitation Chiropractor	CH9004	FL

General Provider Information

NPI Number	:	1285733212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL L GUADAGNO D.C.

Provider Business Mailing Address
First Line	:	7801 SW 133RD CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-3319
Country	:	US
Telephone Number	:	786-701-8671
Fax Number	:

Provider Business Practice Location Address
First Line	:	6075 SUNSET DR 203
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5000
Country	:	US
Telephone Number	:	305-971-0302
Fax Number	:	305-971-8222

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	07/15/2015

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