Healthcare Provider Details

I. General information

NPI: 1912193236
Provider Name (Legal Business Name): CHIROPRACTIC ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7170 SW 117TH AVE
MIAMI FL
33183-2808
US

IV. Provider business mailing address

7170 SW 117TH AVE
MIAMI FL
33183-2808
US

V. Phone/Fax

Practice location:
  • Phone: 305-598-8788
  • Fax: 305-598-8588
Mailing address:
  • Phone: 305-598-8788
  • Fax: 305-598-8588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCH 7736
License Number StateFL

VIII. Authorized Official

Name: DR. JOSEPH P. GAMBARDELLA
Title or Position: DOCTOR
Credential: D.C., C,C.S.P.
Phone: 305-598-8788