Provider Demographics
NPI:1427203439
Name:COMPLETE CHIROPRACTIC HEALTH CENTER OF FLORIDA INC
Entity Type:Organization
Organization Name:COMPLETE CHIROPRACTIC HEALTH CENTER OF FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:N
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-666-5454
Mailing Address - Street 1:6237 SUNSET DR
Mailing Address - Street 2:STE A
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4848
Mailing Address - Country:US
Mailing Address - Phone:305-666-5454
Mailing Address - Fax:305-666-5451
Practice Address - Street 1:6237 SUNSET DR
Practice Address - Street 2:STE A
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4848
Practice Address - Country:US
Practice Address - Phone:305-666-5454
Practice Address - Fax:305-666-5451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7606111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU79565Medicare UPIN
FLHF418AMedicare PIN