Provider Demographics
NPI:1528066933
Name:CARUSO, ERNEST S JR (DC)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:S
Last Name:CARUSO
Suffix:JR
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 1:3350 NW BOCA RATON BLVD
Mailing Address - Street 2:SUITE A24
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6657
Mailing Address - Country:US
Mailing Address - Phone:561-447-2228
Mailing Address - Fax:561-447-2230
Practice Address - Street 1:3350 NW BOCA RATON BLVD
Practice Address - Street 2:SUITE A24
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6657
Practice Address - Country:US
Practice Address - Phone:561-447-2228
Practice Address - Fax:561-447-2230
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-09
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7975111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381811000Medicaid
FL381811000Medicaid
FL53921Medicare PIN