MEDICARE: TOTAL HEALTH CARE PHYSICIANS

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	CH7709	FL

General Provider Information

NPI Number	:	1689624801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL HEALTH CARE PHYSICIANS

Provider Business Mailing Address
First Line	:	2509 N ANDREWS AVE
Second Line	:
City	:	WILTON MANORS
State	:	FL
Zip	:	33311-2507
Country	:	US
Telephone Number	:	954-537-2004
Fax Number	:	954-616-0106

Provider Business Practice Location Address
First Line	:	2509 N ANDREWS AVE
Second Line	:
City	:	WILTON MANORS
State	:	FL
Zip	:	33311-2507
Country	:	US
Telephone Number	:	954-537-2004
Fax Number	:	954-616-0106

Authorized Official
Title or Position	:	PRES.
Name	:	DR. RICHARD JOSEPH POMELLA
Credential	:	DC
Telephone Number	:	954-537-2004

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	08/22/2020

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