Healthcare Provider Details

I. General information

NPI: 1396375861
Provider Name (Legal Business Name): HEALTH & WELLNESS CHIROPRACTIC CENTERS OF SOUTH FLORIDA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 01/23/2020
Certification Date: 01/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S MAIN ST STE 200
BELLE GLADE FL
33430-7808
US

IV. Provider business mailing address

PO BOX 223152
WEST PALM BEACH FL
33422-3152
US

V. Phone/Fax

Practice location:
  • Phone: 561-992-8872
  • Fax: 561-584-7803
Mailing address:
  • Phone: 561-992-8872
  • Fax: 561-584-7803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: LAVITA THOMPSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 561-352-8294