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General NPI Number Information
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NPI Number | 1184988297
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Entity Type | Organization
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Legal Business Name | SOUTH MIAMI CHIROPRACTIC
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Dates
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Enumeration Date | 07/03/2012
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Last Update Date | 07/03/2012
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Provider Practice Location Address
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Address Line | 6075 SW 72ND ST STE 203
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5000
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Country | US
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Telephone | 786-433-7344
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Fax | 786-433-7345
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Provider Business Mailing Address
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Address Line | 6075 SW 72ND ST STE 203
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5000
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Country | US
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Telephone | 786-433-7344
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Fax | 786-433-7345
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Authorized Official
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Title or Position | OWNER
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Name | JASON BAILEY
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Credential | DL
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Telephone | 786-433-7344
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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 |
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License Number State |
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