Provider Demographics
NPI:1760696785
Name:GOETZ, CHRISTOPHER (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:GOETZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 SW 116TH AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-1713
Mailing Address - Country:US
Mailing Address - Phone:305-670-0055
Mailing Address - Fax:305-670-0054
Practice Address - Street 1:9425 SUNSET DR STE 130
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3295
Practice Address - Country:US
Practice Address - Phone:305-216-1964
Practice Address - Fax:305-670-0054
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7230111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55542Medicare ID - Type UnspecifiedMEDICARE
FLU67426Medicare UPIN