Provider Demographics
NPI:1164550844
Name:CITADEL CHIROPRACTIC II, P.A.
Entity Type:Organization
Organization Name:CITADEL CHIROPRACTIC II, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WEDLER
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALEXANDRE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-752-5354
Mailing Address - Street 1:660 W BOYNTON BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-3637
Mailing Address - Country:US
Mailing Address - Phone:561-752-5354
Mailing Address - Fax:561-752-5868
Practice Address - Street 1:1489 N MILITARY TRL
Practice Address - Street 2:SUITE 202
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6029
Practice Address - Country:US
Practice Address - Phone:561-721-9282
Practice Address - Fax:561-721-3880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty