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General NPI Number Information
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NPI Number | 1366776510
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Entity Type | Organization
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Legal Business Name | SOBE WELL, P.A.
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Dates
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Enumeration Date | 09/21/2009
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Last Update Date | 09/21/2009
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Provider Practice Location Address
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Address Line | 3121 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33134-6816
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Country | US
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Telephone | 305-598-6767
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Fax | 305-598-6766
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Provider Business Mailing Address
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Address Line | 3121 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33134-6816
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Country | US
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Telephone | 305-598-6767
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Fax | 305-598-6766
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | PATRECE ADELE FRISBEE
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Credential | D.C.
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Telephone | 305-598-6767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | CH6620
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | CH6620
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH6620
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License Number State | FL
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