Healthcare Provider Details

I. General information

NPI: 1902517618
Provider Name (Legal Business Name): ZIMMERMAN SPORTS CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 S SHORE DR
MIRAMAR BEACH FL
32550-5821
US

IV. Provider business mailing address

30 S SHORE DR
MIRAMAR BEACH FL
32550-5821
US

V. Phone/Fax

Practice location:
  • Phone: 850-312-1456
  • Fax:
Mailing address:
  • Phone: 850-312-1456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ADAM ZIMMERMAN
Title or Position: OWNER
Credential: DC
Phone: 850-312-1456