MEDICARE: CHIROCARE MEDICAL EXPRESS CENTER LLC

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	261QM1300X	Multi-Specialty Clinic/Center		FL

General Provider Information

NPI Number	:	1275807018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROCARE MEDICAL EXPRESS CENTER LLC

Provider Business Mailing Address
First Line	:	5140 COCONUT CREEK PKWY
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-3913
Country	:	US
Telephone Number	:	954-974-0952
Fax Number	:	954-974-0958

Provider Business Practice Location Address
First Line	:	5140 COCONUT CREEK PKWY
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-3913
Country	:	US
Telephone Number	:	954-974-0952
Fax Number	:	954-974-0958

Authorized Official
Title or Position	:	PRACTICE MANAGER/RMA
Name	:	MRS. LETICIA ARROYO
Credential	:	RMA
Telephone Number	:	561-351-6513

Provider Enumeration Date	:	02/24/2012
Last Update Date	:	02/24/2012

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