Healthcare Provider Details

I. General information

NPI: 1891109914
Provider Name (Legal Business Name): WENZEL CENTER FOR CHIROPRACTIC & ALTERNATIVE MEDICINE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 04/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7015 BERACASA WAY STE 103
BOCA RATON FL
33433-3453
US

IV. Provider business mailing address

7015 BERACASA WAY STE 103
BOCA RATON FL
33433-3453
US

V. Phone/Fax

Practice location:
  • Phone: 561-955-9400
  • Fax:
Mailing address:
  • Phone: 561-955-9400
  • Fax: 561-955-1988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7189
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: IRA WENZEL
Title or Position: PRES
Credential:
Phone: 561-955-9400