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General NPI Number Information
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NPI Number | 1558651489
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Entity Type | Organization
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Legal Business Name | KENDALL CHIRO, LLC
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Dates
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Enumeration Date | 04/12/2011
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Last Update Date | 04/12/2011
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Provider Practice Location Address
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Address Line | 13501 SW 136TH ST SUITE 202
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City | MIAMI
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State | FL
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Zip | 33186-8319
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Country | US
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Telephone | 305-761-6528
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Fax | 305-675-0863
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Provider Business Mailing Address
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Address Line | PO BOX 4533
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City | HIALEAH
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State | FL
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Zip | 33014-0533
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Country | US
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Telephone | 305-761-6528
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Fax | 305-675-0863
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Authorized Official
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Title or Position | MGRM
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Name | DR. KEREN HAPUC GOMEZ
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Credential | D.C.
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Telephone | 305-761-6528
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | CH9468
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License Number State | FL
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