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NPI Code Detail

MEDICARE: BAHRAM KHANALI DC

MEDICARE:   BAHRAM  KHANALI  DC
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
1111N00000XChiropractorCH8546FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
170000OTHERFLBCBS OF FL

General Provider Information

NPI Number : 1093766636
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAHRAM KHANALI DC
Provider Business Mailing Address
First Line : 7504 SW 29TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33155-2719
Country : US
Telephone Number : 786-388-0273
Fax Number : 786-388-0273
Provider Business Practice Location Address
First Line : 3090 SW 37TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33133-4311
Country : US
Telephone Number : 305-351-1348
Fax Number : 305-444-7866
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 07/09/2007

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Directions to “ BAHRAM KHANALI DC” Practice Location

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