Provider Demographics
NPI:1760663652
Name:MARTINGANO, DANIEL BRIAN (DC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:BRIAN
Last Name:MARTINGANO
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 1:1320 PALM BAY RD NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-3837
Mailing Address - Country:US
Mailing Address - Phone:321-729-9430
Mailing Address - Fax:321-676-6049
Practice Address - Street 1:1320 PALM BAY RD NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-3837
Practice Address - Country:US
Practice Address - Phone:321-729-9430
Practice Address - Fax:321-676-6049
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9366111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor