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General NPI Number Information
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NPI Number | 1841465663
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Entity Type | Organization
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Legal Business Name | TRANQUIL LIFESTYLES, LLC
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 850 IVES DAIRY RD STE T18
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City | MIAMI
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State | FL
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Zip | 33179-2420
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Country | US
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Telephone | 305-770-2221
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1553
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City | HALLANDALE
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State | FL
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Zip | 33008-1553
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EDWIN M NESI
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Credential | DC
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Telephone | 305-493-3556
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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 | CH9326
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License Number State | FL
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