Healthcare Provider Details
I. General information
NPI: 1710495395
Provider Name (Legal Business Name): C.O.R. INJURY CENTERS OF NORTH MIAMI INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/17/2018
Last Update Date: 01/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12550 BISCAYNE BLVD STE 907
NORTH MIAMI FL
33181-2547
US
IV. Provider business mailing address
12550 BISCAYNE BLVD STE 907
NORTH MIAMI FL
33181-2547
US
V. Phone/Fax
- Phone: 305-895-0307
- Fax:
- Phone: 305-895-0337
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ZERIOSHA
ZAPARA
Title or Position: OWNER
Credential:
Phone: 305-895-0337