Provider Demographics
NPI:1528187036
Name:SPIRELLI HEALTHCARE OF BROWARD
Entity Type:Organization
Organization Name:SPIRELLI HEALTHCARE OF BROWARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:SPIRELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-972-2255
Mailing Address - Street 1:20423 STATE ROAD 7
Mailing Address - Street 2:F-6, #259
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6797
Mailing Address - Country:US
Mailing Address - Phone:954-972-2255
Mailing Address - Fax:
Practice Address - Street 1:4974 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5300
Practice Address - Country:US
Practice Address - Phone:954-972-2255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006771111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55188OtherBCBS
FL55188Medicare ID - Type Unspecified
FL55188OtherBCBS