Provider Demographics
NPI:1851457097
Name:MERLINO, KEVIN S (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:S
Last Name:MERLINO
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 1:10870 US HIGHWAY 1 N
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-7803
Mailing Address - Country:US
Mailing Address - Phone:201-248-9609
Mailing Address - Fax:
Practice Address - Street 1:212 CORNWALL DR
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32081-0126
Practice Address - Country:US
Practice Address - Phone:201-248-9609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13748111N00000X
NJ38MC00573900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU82191Medicare UPIN
NJ045645Medicare PIN