Provider Demographics
NPI:1760783930
Name:PALMINTERI, CHARLES MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:MATTHEW
Last Name:PALMINTERI
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 1:5353 N FEDERAL HWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-3245
Mailing Address - Country:US
Mailing Address - Phone:954-491-8127
Mailing Address - Fax:954-491-2388
Practice Address - Street 1:5353 N FEDERAL HWY
Practice Address - Street 2:SUITE 220
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3245
Practice Address - Country:US
Practice Address - Phone:954-491-8127
Practice Address - Fax:954-491-2388
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05364111N00000X
FLCH10682111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor