Provider Demographics
NPI:1689786113
Name:MIAMI BEACH NATURAL SPORTS MEDICINE, INC.
Entity Type:Organization
Organization Name:MIAMI BEACH NATURAL SPORTS MEDICINE, INC.
Other - Org Name:MIAMI BEACH FAMILY & SPORTS CHIROPRACTICE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:NARSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC CCSP
Authorized Official - Phone:305-672-2225
Mailing Address - Street 1:400 ARTHUR GODFREY RD
Mailing Address - Street 2:SUITE 412
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3516
Mailing Address - Country:US
Mailing Address - Phone:305-672-2225
Mailing Address - Fax:305-674-4449
Practice Address - Street 1:400 ARTHUR GODFREY RD
Practice Address - Street 2:SUITE 412
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3516
Practice Address - Country:US
Practice Address - Phone:305-672-2225
Practice Address - Fax:305-674-4449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380939100Medicaid
U29885Medicare UPIN
FL380939100Medicaid