MEDICARE: DISCOVERY ASSOCIATION, LLC

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

General Provider Information

NPI Number	:	1801549480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DISCOVERY ASSOCIATION, LLC

Provider Business Mailing Address
First Line	:	5348 COQUINA SHORES LN
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32128-3009
Country	:	US
Telephone Number	:	845-544-5359
Fax Number	:

Provider Business Practice Location Address
First Line	:	5348 COQUINA SHORES LN
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32128-3009
Country	:	US
Telephone Number	:	845-544-5359
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PARTNER
Name	:	DR. ELYSSA NAOMI PAGAN
Credential	:	DC
Telephone Number	:	845-544-5359

Provider Enumeration Date	:	02/02/2022
Last Update Date	:	02/02/2022

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