MEDICARE: DR. MICHAEL VINCENT SHONTZ 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	CH6572	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	:	1831184217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL VINCENT SHONTZ DC

Provider Business Mailing Address
First Line	:	2326 US HIGHWAY 19
Second Line	:
City	:	HOLIDAY
State	:	FL
Zip	:	34691-3939
Country	:	US
Telephone Number	:	727-937-4191
Fax Number	:	727-942-4331

Provider Business Practice Location Address
First Line	:	2326 US HIGHWAY 19
Second Line	:
City	:	HOLIDAY
State	:	FL
Zip	:	34691-3939
Country	:	US
Telephone Number	:	727-937-4191
Fax Number	:	727-942-4331

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	10/25/2010

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Directions to “ DR. MICHAEL VINCENT SHONTZ DC” Practice Location

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