Provider Demographics
NPI:1417033747
Name:AMARAL CHIROPRACTIC CENTER PA
Entity Type:Organization
Organization Name:AMARAL CHIROPRACTIC CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:AMARAL-MOJICA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-721-5543
Mailing Address - Street 1:210 N UNIVERSITY DRIVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071
Mailing Address - Country:US
Mailing Address - Phone:954-721-5543
Mailing Address - Fax:
Practice Address - Street 1:210 N UNIVERSITY DR
Practice Address - Street 2:SUITE 209
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7394
Practice Address - Country:US
Practice Address - Phone:954-721-5543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-30
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007383111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55676OtherBCBS
FL381752100Medicaid
FL381752100Medicaid
FL55676Medicare ID - Type Unspecified