Provider Demographics
NPI:1083627871
Name:ADDUCI, MARK ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALAN
Last Name:ADDUCI
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:7301A WEST PALMETTO PARK ROAD
Mailing Address - Street 2:SUITE #203C
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433
Mailing Address - Country:US
Mailing Address - Phone:561-368-6753
Mailing Address - Fax:561-361-9714
Practice Address - Street 1:7301A WEST PALMETTO PARK ROAD
Practice Address - Street 2:SUITE #203C
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433
Practice Address - Country:US
Practice Address - Phone:561-368-6753
Practice Address - Fax:561-368-6753
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004683111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T55042Medicare UPIN
70741Medicare ID - Type Unspecified