Healthcare Provider Details

I. General information

NPI: 1962537449
Provider Name (Legal Business Name): CENTRAL BROWARD THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 SW 26TH AVENUE
POMPANO BEACH FL
33069-3003
US

IV. Provider business mailing address

817 S UNIVERSITY DR SUITE 105
PLANTATION FL
33324-3309
US

V. Phone/Fax

Practice location:
  • Phone: 954-973-1913
  • Fax: 954-973-7426
Mailing address:
  • Phone: 954-424-9724
  • Fax: 954-424-9533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH7549
License Number StateFL

VIII. Authorized Official

Name: DR. SERGIO MAURICO TRIANA
Title or Position: OWNER
Credential: D.C.
Phone: 954-973-1913