Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH13299 | FL |
NPI | 1003403288 |
---|---|
Provider Name | Gianpaolo Antonino Passeggiata |
First Address | Jacksonville, FL 32216-8066 |
Second Address | Jacksonville, FL 32256-5004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2020 |
Last Update Date | 22/12/2020 |