Provider Demographics
NPI:1316384563
Name:GRASSO, MICHAEL BENJAMIN (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BENJAMIN
Last Name:GRASSO
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 1:1836 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-3311
Mailing Address - Country:US
Mailing Address - Phone:561-243-0233
Mailing Address - Fax:561-243-0263
Practice Address - Street 1:1836 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-3311
Practice Address - Country:US
Practice Address - Phone:561-243-0233
Practice Address - Fax:561-243-0263
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10895111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor