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General NPI Number Information
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NPI Number | 1003096207
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA CHIROPRACTIC & REHABILITATION INC
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 07/21/2009
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Provider Practice Location Address
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Address Line | 299 W. CAMINO GARDENS BLVD SUITE 103
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City | BOCA RATON
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State | FL
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Zip | 33432-5822
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Country | US
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Telephone | 561-395-9299
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Fax | 561-395-7995
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Provider Business Mailing Address
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Address Line | 299 W. CAMINO GARDENS BLVD SUITE 103
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City | BOCA RATON
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State | FL
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Zip | 33432-5822
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Country | US
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Telephone | 561-395-9299
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Fax | 561-395-7995
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. NATALIA FANO
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Credential |
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Telephone | 561-395-9299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME37335
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH8413
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License Number State | FL
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