Provider Demographics
NPI:1730339516
Name:SALVATORE J. MARTINGANO, D.C., P.A.
Entity type:Organization
Organization Name:SALVATORE J. MARTINGANO, D.C., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARTINGANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:321-729-9430
Mailing Address - Street 1:1320 PALM BAY RD NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-3837
Mailing Address - Country:US
Mailing Address - Phone:321-729-9430
Mailing Address - Fax:321-676-6049
Practice Address - Street 1:1320 PALM BAY RD NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-3837
Practice Address - Country:US
Practice Address - Phone:321-729-9430
Practice Address - Fax:321-676-6049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 5140111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380176400Medicaid
FLT94445Medicare UPIN
FL70731Medicare PIN