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General NPI Number Information
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NPI Number | 1104957158
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Entity Type | Organization
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Legal Business Name | HALLANDALE MEDICAL ASSOCIATES, INC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 644 W HALLANDALE BEACH BLVD
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-5331
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Country | US
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Telephone | 954-457-8898
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Fax | 954-457-8809
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Provider Business Mailing Address
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Address Line | 644 W HALLANDALE BEACH BLVD
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-5331
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Country | US
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Telephone | 954-457-8898
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Fax | 954-457-8809
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRANK RODRIGUEZ
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Credential | D.C.
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Telephone | 954-457-8898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH5384
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License Number State | FL
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