MEDICARE: OCEAN HEALTH CENTER

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	:	1912575291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEAN HEALTH CENTER

Provider Business Mailing Address
First Line	:	3301 NE 32ND AVE APT 403
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-7121
Country	:	US
Telephone Number	:	954-817-3635
Fax Number	:	954-686-8806

Provider Business Practice Location Address
First Line	:	1348 SE 17TH ST
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-1708
Country	:	US
Telephone Number	:	954-817-3635
Fax Number	:	954-686-8806

Authorized Official
Title or Position	:	OWNER/DR
Name	:	DR. ADAM FACKLER
Credential	:	DR
Telephone Number	:	954-817-3635

Provider Enumeration Date	:	06/14/2021
Last Update Date	:	06/14/2021

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Directions to “OCEAN HEALTH CENTER ” Practice Location

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