Provider Demographics
NPI:1275571598
Name:ADRAGNA, WILLIAM VITO (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:VITO
Last Name:ADRAGNA
Suffix:
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 1:13550 JOG RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-3802
Mailing Address - Country:US
Mailing Address - Phone:561-819-6281
Mailing Address - Fax:561-819-6278
Practice Address - Street 1:13550 JOG RD
Practice Address - Street 2:SUITE 203
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-3802
Practice Address - Country:US
Practice Address - Phone:561-819-6281
Practice Address - Fax:561-819-6278
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6104111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22640Medicare ID - Type Unspecified
FL19676Medicare UPIN