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General NPI Number Information
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NPI Number | 1417056128
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Entity Type | Organization
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Legal Business Name | SUNNY ISLES MEDICAL-ASSOCIATES INC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 01/17/2008
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Provider Practice Location Address
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Address Line | 2760 WEST SUNRISE BOULEVARD
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City | SUNRISE
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State | FL
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Zip | 33311
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Country | US
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Telephone | 954-583-9555
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Fax | 954-797-8699
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Provider Business Mailing Address
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Address Line | 2760 WEST SUNRISE BOULEVARD
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City | SUNRISE
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State | FL
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Zip | 33311
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Country | US
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Telephone | 954-583-9555
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Fax | 954-797-8699
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | FRANK RODRIGUEZ
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Credential | D.C.
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Telephone | 305-933-9929
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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 | CH 5384
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License Number State | FL
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