Provider Demographics
NPI:1871500173
Name:TOTINO, LISA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:MARIE
Last Name:TOTINO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 NE 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-1639
Mailing Address - Country:US
Mailing Address - Phone:954-767-0993
Mailing Address - Fax:954-767-0994
Practice Address - Street 1:20 NE 8TH AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-1639
Practice Address - Country:US
Practice Address - Phone:954-767-0993
Practice Address - Fax:954-767-0994
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6702111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor