Provider Demographics
NPI:1821112004
Name:DWF II CORPORATION
Entity Type:Organization
Organization Name:DWF II CORPORATION
Other - Org Name:FALLS CHIROPRACTIC HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:305-233-6325
Mailing Address - Street 1:13813 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-7221
Mailing Address - Country:US
Mailing Address - Phone:305-233-6325
Mailing Address - Fax:305-254-6980
Practice Address - Street 1:13813 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-7221
Practice Address - Country:US
Practice Address - Phone:305-233-6325
Practice Address - Fax:305-254-6980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7127111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU69882Medicare UPIN
FL55471Medicare ID - Type Unspecified