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NPI Code Detail

MEDICARE: PLARIDEL JOHN TORDILLA D.C.

MEDICARE: PLARIDEL JOHN TORDILLA 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
1111N00000XChiropractorCH9676FL

General Provider Information

NPI Number : 1922236298
Entity Type Code : Individual
Provider Name (Legal Business Name) : PLARIDEL JOHN TORDILLA D.C.
Provider Business Mailing Address
First Line : 7100 W COMMERCIAL BLVD
Second Line : SUITE # 110
City : LAUDERHILL
State : FL
Zip : 33319-2155
Country : US
Telephone Number : 954-742-4713
Fax Number : 954-742-9692
Provider Business Practice Location Address
First Line : 7100 W COMMERCIAL BLVD
Second Line : SUITE # 110
City : LAUDERHILL
State : FL
Zip : 33319-2155
Country : US
Telephone Number : 954-742-4713
Fax Number : 954-742-9692
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2009
Last Update Date : 06/25/2009

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