Provider Demographics
NPI:1285733212
Name:GUADAGNO, PAUL L (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:L
Last Name:GUADAGNO
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 1:7801 SW 133RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-3319
Mailing Address - Country:US
Mailing Address - Phone:786-701-8671
Mailing Address - Fax:
Practice Address - Street 1:6075 SUNSET DR 203
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5000
Practice Address - Country:US
Practice Address - Phone:305-971-0302
Practice Address - Fax:305-971-8222
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9004111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU83780Medicare UPIN
FL70025Medicare ID - Type Unspecified