Dr. Matthew J. Tavolacci DC, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH10273 Issued in FL

Legal business name

DR. MATTHEW J. TAVOLACCI DC, LLC

Practice address

12797 Forest Hill Blvd
Suite B
Wellington, FL 33414-4763

Phone

(561) 793-5550

NPI assigned

Sep 7, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Matthew John Tavolacci, D.C.

Title

Chiropractor/Owner

Phone

(561) 793-5550

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315353600000",
    "number": "1538440326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12797 FOREST HILL BLVD",
            "address_2": "SUITE B",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144763",
            "telephone_number": "561-793-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12797 FOREST HILL BLVD",
            "address_2": "SUITE B",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144763",
            "telephone_number": "561-793-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MATTHEW J. TAVOLACCI DC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-07",
        "last_updated": "2011-09-07",
        "status": "A",
        "authorized_official_last_name": "TAVOLACCI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "561-793-5550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.