Provider Demographics
NPI:1235177429
Name:AMATO, JENNIFER ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANN
Last Name:AMATO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5932 VISTA LINDA LN
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-8230
Mailing Address - Country:US
Mailing Address - Phone:516-749-1468
Mailing Address - Fax:516-385-8144
Practice Address - Street 1:6853 SW 18TH ST STE 220
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-7056
Practice Address - Country:US
Practice Address - Phone:516-749-1468
Practice Address - Fax:516-385-8144
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14398111NS0005X
NYX011118-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV07318Medicare UPIN
NYX03D42Medicare ID - Type Unspecified