MEDICARE: HOLLYWOOD FAMILY CHIROPRACTIC CENTER

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	CH 5528	FL

General Provider Information

NPI Number	:	1407281843
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLLYWOOD FAMILY CHIROPRACTIC CENTER

Provider Business Mailing Address
First Line	:	2030 WASHINGTON ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-6930
Country	:	US
Telephone Number	:	954-505-7743
Fax Number	:	954-505-7744

Provider Business Practice Location Address
First Line	:	2030 WASHINGTON ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-6930
Country	:	US
Telephone Number	:	954-505-7743
Fax Number	:	954-505-7744

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TIM G TSIOTSIAS
Credential	:	D.C
Telephone Number	:	954-505-7743

Provider Enumeration Date	:	09/04/2013
Last Update Date	:	09/04/2013

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