Individual
FRED PATRICK DELLA JACONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AP,LMT
Contact information
Practice address
4400 W SAMPLE RD STE 240, COCONUT CREEK, FL 33073-3473
(754) 326-1127
Mailing address
2330 NW 37TH WAY, COCONUT CREEK, FL 33066-2261
(954) 488-3388
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
14560
FL
171100000X
Acupuncturist
Primary
4006
FL
225700000X
Massage Therapist
46183
FL
Other
Enumeration date
12/04/2018
Last updated
01/22/2026
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