MEDICARE: MIYOASHI GAY 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	CH 10139	FL

General Provider Information

NPI Number	:	1922306851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIYOASHI GAY D.C

Provider Business Mailing Address
First Line	:	2015 ERVING CIR
Second Line	:	#5-303
City	:	OCOEE
State	:	FL
Zip	:	34761-6827
Country	:	US
Telephone Number	:	305-502-4725
Fax Number	:

Provider Business Practice Location Address
First Line	:	927 S GOLDWYN AVE
Second Line	:	SUITE 220
City	:	ORLANDO
State	:	FL
Zip	:	32805-4324
Country	:	US
Telephone Number	:	407-574-8542
Fax Number	:	407-574-4582

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

Provider Enumeration Date	:	03/01/2011
Last Update Date	:	02/12/2013

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