MEDICARE: FLORIDA CHIROPRACTIC, 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	:	1821866989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	4402 MARTINIQUE CT APT D4
Second Line	:
City	:	COCONUT CREEK
State	:	FL
Zip	:	33066-1425
Country	:	US
Telephone Number	:	561-667-6237
Fax Number	:

Provider Business Practice Location Address
First Line	:	5975 N FEDERAL HWY STE 121
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-2661
Country	:	US
Telephone Number	:	954-771-3800
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. MUHAMMAD HEIBA
Credential	:	DC
Telephone Number	:	561-667-6237

Provider Enumeration Date	:	12/18/2023
Last Update Date	:	12/18/2023

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