Healthcare Provider Details

I. General information

NPI: 1699731190
Provider Name (Legal Business Name): BACK TO HEALTH OF SOUTH FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 CAMINO GARDENS BLVD SUITE 201
BOCA RATON FL
33432-5823
US

IV. Provider business mailing address

301 CAMINO GARDENS BLVD SUITE 201
BOCA RATON FL
33432-5823
US

V. Phone/Fax

Practice location:
  • Phone: 561-394-8770
  • Fax: 561-394-3615
Mailing address:
  • Phone: 561-394-8770
  • Fax: 561-394-3615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH8206
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License NumberME87065
License Number StateFL

VIII. Authorized Official

Name: DR. XAVIER M ESCOBAR
Title or Position: PRESIDENT
Credential: DC
Phone: 561-394-8770