Provider Demographics
NPI:1477663342
Name:BATTILLO, ANTHONY WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:WAYNE
Last Name:BATTILLO
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 1:9000 SW 87TH CT
Mailing Address - Street 2:SUITE # 114
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2231
Mailing Address - Country:US
Mailing Address - Phone:305-596-5221
Mailing Address - Fax:305-596-7221
Practice Address - Street 1:9000 SW 87TH CT
Practice Address - Street 2:SUITE # 114
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2231
Practice Address - Country:US
Practice Address - Phone:305-596-5221
Practice Address - Fax:305-596-7221
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8189111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
89479ZMedicare ID - Type Unspecified