MEDICARE: BACK TO MIND N MIAMI 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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1609741511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BACK TO MIND N MIAMI LLC

Provider Business Mailing Address
First Line	:	3990 SHERIDAN ST STE 201
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3656
Country	:	US
Telephone Number	:	954-986-4559
Fax Number	:	954-986-4526

Provider Business Practice Location Address
First Line	:	1125 NE 125TH ST STE 303
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-5017
Country	:	US
Telephone Number	:	954-986-4559
Fax Number	:	954-986-4526

Authorized Official
Title or Position	:	CO-OWNER
Name	:	LIAT ABRAMSON
Credential	:
Telephone Number	:	305-766-8997

Provider Enumeration Date	:	10/09/2025
Last Update Date	:	10/09/2025

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