MEDICARE: MR. ALEXIS SAMANIEGO 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	CH10980	FL

General Provider Information

NPI Number	:	1477987980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALEXIS SAMANIEGO DC

Provider Business Mailing Address
First Line	:	4170 TOWN CTR BLVD
Second Line	:	SUITE 100
City	:	ORLANDO
State	:	FL
Zip	:	32837-5873
Country	:	US
Telephone Number	:	407-857-6166
Fax Number	:

Provider Business Practice Location Address
First Line	:	4170 TOWN CTR BLVD
Second Line	:	SUITE 100
City	:	ORLANDO
State	:	FL
Zip	:	32837-5873
Country	:	US
Telephone Number	:	407-857-6166
Fax Number	:

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

Provider Enumeration Date	:	09/03/2013
Last Update Date	:	09/03/2013

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