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General NPI Number Information
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NPI Number | 1295345932
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Entity Type | Organization
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Legal Business Name | HOUSECALLSPINEDOCTOR-COM LLC
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Dates
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Enumeration Date | 08/07/2020
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 221 W HALLANDALE BEACH BLVD # 346
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-5441
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Country | US
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Telephone | 800-315-7611
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Fax | 305-723-3334
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Provider Business Mailing Address
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Address Line | 221 W HALLANDALE BEACH BLVD # 346
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-5441
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Country | US
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Telephone | 800-315-7611
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Fax | 305-723-3334
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUDE ALCIDE
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Credential | DC
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Telephone | 800-315-7611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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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 |
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License Number State |
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