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Organization
DR. TONY D'AGOSTINO DC PA
Active
Organization
DR. TONY D'AGOSTINO DC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY D'AGOSTINO D.C. (PRESIDENT)
(239) 573-8918
Entity
Organization
Contact information
Practice address
1338 DEL PRADO BLVD S STE 8, CAPE CORAL, FL 33990-3714
(239) 910-7182
Mailing address
1338 DEL PRADO BLVD S STE 8, CAPE CORAL, FL 33990-3714
(239) 910-7182
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH7971
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53909Z
INDIVIDUAL PTAN
FL
01
—
CH7971
STATE LICENSE NUMBER
FL
01
—
FB090A
GROUP PTAN
FL
Enumeration date
06/17/2011
Last updated
07/19/2011
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