MEDICARE: ATRIUM CHIROPRACTIC CENTER 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	261QP2300X	Primary Care Clinic/Center	CH6060	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366772998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATRIUM CHIROPRACTIC CENTER INC.

Provider Business Mailing Address
First Line	:	15118 SW 72ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33193-3228
Country	:	US
Telephone Number	:	305-386-9559
Fax Number	:	305-386-9561

Provider Business Practice Location Address
First Line	:	15118 SW 72ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33193-3228
Country	:	US
Telephone Number	:	305-386-9559
Fax Number	:	305-386-9561

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. ADOLFO CARLO GUADAGNO
Credential	:	D.C.
Telephone Number	:	305-386-9559

Provider Enumeration Date	:	01/04/2010
Last Update Date	:	01/04/2010

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