Provider Demographics
NPI:1174553606
Name:MANCINI, ANDREW ARDUICO II (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:ARDUICO
Last Name:MANCINI
Suffix:II
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 1:14577 SOUTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-9227
Mailing Address - Country:US
Mailing Address - Phone:561-792-8474
Mailing Address - Fax:561-792-8460
Practice Address - Street 1:14577 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9227
Practice Address - Country:US
Practice Address - Phone:561-792-8474
Practice Address - Fax:561-792-8460
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU38754Medicare UPIN
FL55758ZMedicare ID - Type Unspecified