Provider Demographics
NPI:1043541238
Name:FAMILY CHIROPRACTIC & WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:FAMILY CHIROPRACTIC & WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-477-6366
Mailing Address - Street 1:10773 NW 58TH ST
Mailing Address - Street 2:# 321
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2801
Mailing Address - Country:US
Mailing Address - Phone:305-477-6366
Mailing Address - Fax:305-594-1733
Practice Address - Street 1:9500 NW 41ST ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2316
Practice Address - Country:US
Practice Address - Phone:305-477-6366
Practice Address - Fax:305-594-1733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-27
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
35101Medicare PIN