MEDICARE: JOSE A PATINO 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	CH 10029	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720399579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE A PATINO D.C.

Provider Business Mailing Address
First Line	:	9407 NW 74TH PL
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-2312
Country	:	US
Telephone Number	:	954-825-8490
Fax Number	:

Provider Business Practice Location Address
First Line	:	3275 W HILLSBORO BLVD STE 210
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-9476
Country	:	US
Telephone Number	:	954-825-8490
Fax Number	:

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

Provider Enumeration Date	:	06/27/2010
Last Update Date	:	08/21/2013

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Directions to “ JOSE A PATINO D.C.” Practice Location

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