Provider Demographics
NPI:1073859039
Name:YOHAM KENDALL AREA CHIROPRACTIC CENTER PA
Entity Type:Organization
Organization Name:YOHAM KENDALL AREA CHIROPRACTIC CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:YOHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-598-1900
Mailing Address - Street 1:11440 N KENDALL DR
Mailing Address - Street 2:SUITE #111
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1044
Mailing Address - Country:US
Mailing Address - Phone:305-598-1900
Mailing Address - Fax:305-598-2130
Practice Address - Street 1:11440 N KENDALL DR
Practice Address - Street 2:SUITE #111
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1024
Practice Address - Country:US
Practice Address - Phone:305-598-1900
Practice Address - Fax:305-598-2130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-19
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGY465AOtherMEDICARE PTAN