MEDICARE: DIVINE MOTION CHIROPRACTIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1043176662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVINE MOTION CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	442 SE 11TH TER
Second Line	:
City	:	DANIA BEACH
State	:	FL
Zip	:	33004-4529
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 OAKWOOD BLVD SUITE 190, UNIT 47/49
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020
Country	:	US
Telephone Number	:	217-693-1609
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	SYDNEY ALVAREZ
Credential	:	DC
Telephone Number	:	217-693-1609

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	12/29/2025

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