Provider Demographics
NPI:1407281843
Name:HOLLYWOOD FAMILY CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:HOLLYWOOD FAMILY CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:G
Authorized Official - Last Name:TSIOTSIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-505-7743
Mailing Address - Street 1:2030 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6930
Mailing Address - Country:US
Mailing Address - Phone:954-505-7743
Mailing Address - Fax:954-505-7744
Practice Address - Street 1:2030 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6930
Practice Address - Country:US
Practice Address - Phone:954-505-7743
Practice Address - Fax:954-505-7744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 5528111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty