Organization Active NPI

Tom Latrielle D C PA

  • Chiropractor
  • Fort Lauderdale, FL
National Provider Identifier
1164516233
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0007390 Issued in FL
Legal business name
TOM LATRIELLE D C PA
Practice address
1900 S Ocean Dr
Suite 807
Fort Lauderdale, FL 33316-3763
Phone
(954) 553-2222
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Tom C Latrielle, DC
Title
Officer
Phone
(954) 553-2222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH0007390 FL Primary

Addresses

Primary practice location

1900 S Ocean Dr
Suite 807
Fort Lauderdale, FL 33316-3763

Mailing address

1900 S Ocean Dr
Suite 807
Fort Lauderdale, FL 33316-3763
Phone (954) 553-2222

Other identifiers 1

IdentifierTypeStateIssuer
70024OtherFLBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164516233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 S OCEAN DR",
            "address_2": "SUITE 807",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333163763",
            "telephone_number": "954-553-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S OCEAN DR",
            "address_2": "SUITE 807",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333163763",
            "telephone_number": "954-553-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOM LATRIELLE D C PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LATRIELLE",
        "authorized_official_first_name": "TOM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "954-553-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0007390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "70024",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.