Healthcare Provider Details

I. General information

NPI: 1013249333
Provider Name (Legal Business Name): CAPITAL HEALTHCARE CLINICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2010
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 KENILWORTH AVE SUITE 120
RIVERDALE MD
20737-1331
US

IV. Provider business mailing address

100 S POINTE DR SUITE 1807
MIAMI BEACH FL
33139-7364
US

V. Phone/Fax

Practice location:
  • Phone: 410-318-6253
  • Fax: 410-358-6551
Mailing address:
  • Phone: 410-318-6253
  • Fax: 410-358-6551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. SEMYON FRIEMDAN
Title or Position: PRESIDENT
Credential: PHD
Phone: 410-318-6253