Provider Demographics
NPI:1740581255
Name:NATURAL HEALTH CLINIC INC
Entity Type:Organization
Organization Name:NATURAL HEALTH CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-471-0036
Mailing Address - Street 1:3900 NW 79TH AVE STE 515
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6549
Mailing Address - Country:US
Mailing Address - Phone:305-471-0036
Mailing Address - Fax:305-471-0037
Practice Address - Street 1:3900 NW 79TH AVE STE 515
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6549
Practice Address - Country:US
Practice Address - Phone:305-471-0036
Practice Address - Fax:305-471-0037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMM25670OtherMASSAGE ESTABLISHMENT