Healthcare Provider Details

I. General information

NPI: 1053512319
Provider Name (Legal Business Name): EXCELLENT CARE CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6595 N.W 36ST 304-2
VIRGINIA GARDENS FL
33166
US

IV. Provider business mailing address

6595 N.W 36 ST 304-2
VIRGINIA GARDENS FL
33166
US

V. Phone/Fax

Practice location:
  • Phone: 305-871-9087
  • Fax: 305-871-9097
Mailing address:
  • Phone: 305-871-9087
  • Fax: 305-871-9097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. OSLAIDA SIMON
Title or Position: PRESIDENT
Credential:
Phone: 305-871-9087