MEDICARE: ISLAND HEALTHCARE 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	111N00000X	Chiropractor	CH 4427	FL

General Provider Information

NPI Number	:	1457654105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISLAND HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	4450 S TAMIAMI TRL
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34231-3454
Country	:	US
Telephone Number	:	941-927-7009
Fax Number	:	941-929-9715

Provider Business Practice Location Address
First Line	:	4450 S TAMIAMI TRL
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34231-3454
Country	:	US
Telephone Number	:	941-927-7009
Fax Number	:	941-929-9715

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. MARK ROBERT D'AMATO
Credential	:	D.C.
Telephone Number	:	941-927-7009

Provider Enumeration Date	:	12/17/2010
Last Update Date	:	10/04/2016

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