MEDICARE: NORTHWOOD SPORTS MEDICINE & PHYSICAL REHABILITATION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NR0400X	Rehabilitation Chiropractor	CH1504	FL
2	111NR0400X	Rehabilitation Chiropractor	CH6427	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003037474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWOOD SPORTS MEDICINE & PHYSICAL REHABILITATION INC

Provider Business Mailing Address
First Line	:	2790 N MILITARY TRL
Second Line	:	SUITE 1
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-2926
Country	:	US
Telephone Number	:	561-683-4971
Fax Number	:	561-478-4946

Provider Business Practice Location Address
First Line	:	2790 N MILITARY TRL
Second Line	:	SUITE 1
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-2926
Country	:	US
Telephone Number	:	561-683-4971
Fax Number	:	561-478-4946

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID B ANDERSON
Credential	:	D.C.
Telephone Number	:	561-683-4971

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	10/11/2011

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