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General NPI Number Information
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NPI Number | 1457524787
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Entity Type | Individual
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Provider Name | CORA BOOMER LLERA D.C.
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Gender | Female
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Dates
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Enumeration Date | 04/08/2008
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 4014 CHASE AVE SUITE 210
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3452
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Country | US
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Telephone | 305-672-2998
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Fax | 305-672-7986
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Provider Business Mailing Address
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Address Line | 7411 SABAL DR
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2524
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Country | US
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Telephone | 305-672-2998
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Fax | 305-672-7986
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6276
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License Number State | FL
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