Provider Demographics
NPI:1306818067
Name:AQUINO, ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:AQUINO
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 1:4623 FOREST HILL BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-9120
Mailing Address - Country:US
Mailing Address - Phone:561-966-7194
Mailing Address - Fax:561-966-7191
Practice Address - Street 1:2700 W CYPRESS CREEK RD
Practice Address - Street 2:C100
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1744
Practice Address - Country:US
Practice Address - Phone:954-974-3111
Practice Address - Fax:954-974-6191
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01745191OtherRAILROAD MEDICARE
FLP01745191OtherRAILROAD MEDICARE