Provider Demographics
NPI:1215069588
Name:MAFFUCCI, ANGELO III (DC)
Entity type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:
Last Name:MAFFUCCI
Suffix:III
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 1:1265 S MILITARY TRL STE 110
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-7688
Mailing Address - Country:US
Mailing Address - Phone:954-322-4212
Mailing Address - Fax:
Practice Address - Street 1:1265 SOUTH MILITARY TRAIL
Practice Address - Street 2:SUITE 110
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-7688
Practice Address - Country:US
Practice Address - Phone:954-322-4212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8118111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor