Provider Demographics
NPI:1497933279
Name:HEALTHCORE WELLNESS PA
Entity Type:Organization
Organization Name:HEALTHCORE WELLNESS PA
Other - Org Name:OCEAN VIEW HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:FIERRO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:904-270-2673
Mailing Address - Street 1:1ST STREET NORTH
Mailing Address - Street 2:SUITE 709
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-6944
Mailing Address - Country:US
Mailing Address - Phone:904-270-2673
Mailing Address - Fax:904-278-5554
Practice Address - Street 1:320 1ST ST N
Practice Address - Street 2:SUITE 709
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-6944
Practice Address - Country:US
Practice Address - Phone:904-270-2673
Practice Address - Fax:904-278-5554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8750111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty