MEDICARE: DR. TIM GUS TSIOTSIAS 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	CH0005528	FL

General Provider Information

NPI Number	:	1871737882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIM GUS TSIOTSIAS DC

Provider Business Mailing Address
First Line	:	2030 WASHINGTON ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-6930
Country	:	US
Telephone Number	:	954-505-7743
Fax Number	:	954-505-7744

Provider Business Practice Location Address
First Line	:	2030 WASHINGTON ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-6930
Country	:	US
Telephone Number	:	954-925-7333
Fax Number	:	954-925-7339

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

Provider Enumeration Date	:	04/22/2009
Last Update Date	:	11/11/2019

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