Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CH9004 | FL |
NPI | 1285733212 |
---|---|
Provider Name | Dr. Paul L Guadagno |
First Address | Miami, FL 33183-3319 |
Second Address | South Miami, FL 33143-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 15/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U83780 | (02) | FL |