MEDICARE: DR. EDWARD MICHAEL BUONADONNA 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	CH0007117	FL

General Provider Information

NPI Number	:	1922138635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD MICHAEL BUONADONNA D.C.

Provider Business Mailing Address
First Line	:	21 BALFOUR RD W
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-7090
Country	:	US
Telephone Number	:	561-625-6412
Fax Number	:

Provider Business Practice Location Address
First Line	:	1421 10TH ST
Second Line	:
City	:	LAKE PARK
State	:	FL
Zip	:	33403-2044
Country	:	US
Telephone Number	:	561-863-8898
Fax Number	:	561-863-8380

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

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