Healthcare Provider Details

I. General information

NPI: 1366210759
Provider Name (Legal Business Name): MUHAMMAD HEIBA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2023
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5975 N FEDERAL HWY STE 121
FORT LAUDERDALE FL
33308-2661
US

IV. Provider business mailing address

4402 MARTINIQUE CT APT D4
COCONUT CREEK FL
33066-1425
US

V. Phone/Fax

Practice location:
  • Phone: 954-771-3800
  • Fax:
Mailing address:
  • Phone: 561-667-6237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number14816
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: