Provider Demographics
NPI:1598827461
Name:WINDMILL CHIROPRACTIC P.A.
Entity Type:Organization
Organization Name:WINDMILL CHIROPRACTIC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:BEHAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-217-4881
Mailing Address - Street 1:17160 ROYAL PALM BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-2395
Mailing Address - Country:US
Mailing Address - Phone:954-217-4881
Mailing Address - Fax:954-217-4991
Practice Address - Street 1:17160 ROYAL PALM BLVD STE 1
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-2395
Practice Address - Country:US
Practice Address - Phone:954-217-4881
Practice Address - Fax:954-217-4991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL611612000OtherDOL FECA
FL74518OtherGROUP BCBS
FL74518Medicare ID - Type UnspecifiedPROVIDER NUMBER