MEDICARE: DR. ELYSE SALTALAMACHIA DC,DABCI

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	111NN1001X	Nutrition Chiropractor	CH-9136	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	64079	OTHER	FL	BLUE CROSS BLUE SHEILD

General Provider Information

NPI Number	:	1952520678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELYSE SALTALAMACHIA DC,DABCI

Provider Business Mailing Address
First Line	:	2910 MAGUIRE RD STE 101
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-4719
Country	:	US
Telephone Number	:	407-877-8707
Fax Number	:	407-877-7464

Provider Business Practice Location Address
First Line	:	2910 MAGUIRE RD STE 1009
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-4742
Country	:	US
Telephone Number	:	407-877-8707
Fax Number	:	407-877-7464

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

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	12/04/2018

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