MEDICARE: ALICIA SAVASTANO 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	111NP0017X	Pediatric Chiropractor	CH15189	FL

General Provider Information

NPI Number	:	1609686906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA SAVASTANO DC

Provider Business Mailing Address
First Line	:	12731 WORLD PLAZA LN BLDG 83-1
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-4081
Country	:	US
Telephone Number	:	919-225-1792
Fax Number	:

Provider Business Practice Location Address
First Line	:	12731 WORLD PLAZA LN BLDG 83-1
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-4081
Country	:	US
Telephone Number	:	919-225-1792
Fax Number	:

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

Provider Enumeration Date	:	01/09/2025
Last Update Date	:	01/09/2025

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Directions to “ ALICIA SAVASTANO DC” Practice Location

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