MEDICARE: COUNTY LINE CHIROPRACTIC-NORTH MIAMI BEACH

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	111N00000X	Chiropractor	CH5299	FL

General Provider Information

NPI Number	:	1265680458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY LINE CHIROPRACTIC-NORTH MIAMI BEACH

Provider Business Mailing Address
First Line	:	1855 NE MIAMI GARDENS DR
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33179-5035
Country	:	US
Telephone Number	:	305-937-3711
Fax Number	:	305-937-3011

Provider Business Practice Location Address
First Line	:	1855 NE MIAMI GARDENS DR
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33179-5035
Country	:	US
Telephone Number	:	305-937-3711
Fax Number	:	305-937-3011

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT HOCHSTEIN
Credential	:	D.C.
Telephone Number	:	305-937-3711

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	09/03/2008

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