Healthcare Provider Details

I. General information

NPI: 1184132870
Provider Name (Legal Business Name): COR INJURY CENTERS OF WEST BROWARD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2018
Last Update Date: 01/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 W OAKLAND PARK BLVD
LAUDERHILL FL
33313-1016
US

IV. Provider business mailing address

7000 W OAKLAND PARK BLVD STE 201
LAUDERHILL FL
33313-1016
US

V. Phone/Fax

Practice location:
  • Phone: 954-368-3086
  • Fax:
Mailing address:
  • Phone: 954-368-3086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ZERIOSHA ZAPATA
Title or Position: OWNER
Credential:
Phone: 954-368-3086