Provider Demographics
NPI:1417142688
Name:FAMILY WELLNESS CENTERS INC
Entity Type:Organization
Organization Name:FAMILY WELLNESS CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-498-1098
Mailing Address - Street 1:4723 W ATLANTIC AVE
Mailing Address - Street 2:SUITE A-13
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3895
Mailing Address - Country:US
Mailing Address - Phone:561-498-1098
Mailing Address - Fax:561-495-2524
Practice Address - Street 1:4723 W ATLANTIC AVE
Practice Address - Street 2:SUITE A-13
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3895
Practice Address - Country:US
Practice Address - Phone:561-498-1098
Practice Address - Fax:561-495-2524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7126111N00000X
FLOS7123208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6689360001Medicare NSC