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General NPI Number Information
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NPI Number | 1568559706
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA REHABILITATION & WELLNESS CENTER, INC
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | 7990 SW 117TH AVE SUITE 205
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City | MIAMI
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State | FL
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Zip | 33183-3847
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Country | US
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Telephone | 305-271-7447
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Fax | 305-271-7448
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Provider Business Mailing Address
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Address Line | 7990 SW 117TH AVE SUITE 205
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City | MIAMI
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State | FL
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Zip | 33183-3847
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Country | US
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Telephone | 305-271-7447
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Fax | 305-271-7448
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Authorized Official
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Title or Position | P
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Name | DR. AIXA GOODRICH
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Credential | DC
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Telephone | 305-271-7447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State | FL
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