Provider Demographics
NPI:1396866562
Name:CHIRO-MEDICAL ASSOCIATES OF HOLLYWOOD INC
Entity Type:Organization
Organization Name:CHIRO-MEDICAL ASSOCIATES OF HOLLYWOOD INC
Other - Org Name:CHOICE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONSULTING
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-817-9402
Mailing Address - Street 1:2832 STIRLING RD
Mailing Address - Street 2:UNIT E
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-1127
Mailing Address - Country:US
Mailing Address - Phone:954-929-1211
Mailing Address - Fax:954-929-1213
Practice Address - Street 1:2295 NW CORPORATE BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7323
Practice Address - Country:US
Practice Address - Phone:561-241-1971
Practice Address - Fax:561-241-3969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC3659208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty