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General NPI Number Information
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NPI Number | 1275998007
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Entity Type | Organization
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Legal Business Name | MARISTANY CHIROPRACTIC INC
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Dates
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Enumeration Date | 12/21/2015
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Last Update Date | 07/21/2020
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Provider Practice Location Address
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Address Line | 12773 FOREST HILL BLVD SUITE 201
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City | WELLINGTON
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State | FL
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Zip | 33414-4767
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Country | US
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Telephone | 561-623-7392
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Fax | 561-847-4785
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Provider Business Mailing Address
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Address Line | 12773 FOREST HILL BLVD SUITE 201
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City | WELLINGTON
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State | FL
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Zip | 33414-4767
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Country | US
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Telephone | 561-623-7392
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Fax | 561-847-4785
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANAIS MARISTANY-DIAZ
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Credential | DC
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Telephone | 561-623-7392
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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 | CH9807
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License Number State | FL
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