Provider Demographics
NPI:1346438942
Name:FAMILY CHIROPRACTIC & NUTRITION, INC.
Entity Type:Organization
Organization Name:FAMILY CHIROPRACTIC & NUTRITION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:M
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-353-1945
Mailing Address - Street 1:7491 N FEDERAL HWY
Mailing Address - Street 2:STE C16
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1625
Mailing Address - Country:US
Mailing Address - Phone:561-353-1945
Mailing Address - Fax:561-353-0925
Practice Address - Street 1:7491 N FEDERAL HWY
Practice Address - Street 2:STE C16
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1625
Practice Address - Country:US
Practice Address - Phone:561-353-1945
Practice Address - Fax:561-353-0925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7543111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU82742Medicare UPIN
FL558942Medicare PIN