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General NPI Number Information
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NPI Number | 1992370803
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Entity Type | Organization
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Legal Business Name | MEDA-PEUTICS, LLC
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 11451 SW 43RD DR APT 7203
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City | MIRAMAR
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State | FL
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Zip | 33025-8042
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Country | US
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Telephone | 305-609-4902
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Fax |
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Provider Business Mailing Address
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Address Line | 11451 SW 43RD DR APT 7203
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City | MIRAMAR
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State | FL
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Zip | 33025-8042
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Country | US
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Telephone | 305-609-4902
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. JUSTIN R COLEMAN
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Credential | DC
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Telephone | 305-609-4902
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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