Provider Demographics
NPI:1104838333
Name:AMUNATEGUI, JOSEPH ANTHONY II (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:AMUNATEGUI
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4478
Mailing Address - Country:US
Mailing Address - Phone:954-458-1223
Mailing Address - Fax:954-458-6150
Practice Address - Street 1:1025 E HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4478
Practice Address - Country:US
Practice Address - Phone:954-458-1223
Practice Address - Fax:954-458-6150
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLID 0103025OtherCERT WORKMENS COMP
FL U54977Medicare UPIN
55263Medicare ID - Type Unspecified