Provider Demographics
NPI:1417269127
Name:LAUDERDALE CHIROMED CENTERS, INC
Entity Type:Organization
Organization Name:LAUDERDALE CHIROMED CENTERS, INC
Other - Org Name:SOUTH FLORIDA SPINE & REHAB CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-383-9681
Mailing Address - Street 1:2050 NE 163RD ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1007 W COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3107
Practice Address - Country:US
Practice Address - Phone:954-942-8801
Practice Address - Fax:954-489-1305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-10
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8780111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty