MEDICARE: CHIROCARE MEDICAL 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	261QH0100X	Health Service Clinic/Center	CH7752	FL

General Provider Information

NPI Number	:	1912281809
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROCARE MEDICAL 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	:

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	:

Authorized Official
Title or Position	:	PRACTIC MANAGER
Name	:	MISS JESSICA ARROYO
Credential	:
Telephone Number	:	954-974-0952

Provider Enumeration Date	:	10/11/2011
Last Update Date	:	10/11/2011

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