MEDICARE: DR. SALVATORE DANIEL DIDOMENICO JR. 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	CH0007562	FL

General Provider Information

NPI Number	:	1447329545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SALVATORE DANIEL DIDOMENICO JR. D.C.

Provider Business Mailing Address
First Line	:	7466 EDENMORE ST
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34202-7900
Country	:	US
Telephone Number	:	727-365-4506
Fax Number	:

Provider Business Practice Location Address
First Line	:	5460 63RD ST E
Second Line	:	SUITEB
City	:	BRADENTON
State	:	FL
Zip	:	34203-7808
Country	:	US
Telephone Number	:	941-758-8811
Fax Number	:

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	03/06/2008

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