Provider Demographics
NPI:1821404997
Name:CARRAZANA CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:CARRAZANA CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRAZANA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:786-877-6923
Mailing Address - Street 1:17971 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2578
Mailing Address - Country:US
Mailing Address - Phone:786-877-6923
Mailing Address - Fax:305-222-6199
Practice Address - Street 1:17971 BISCAYNE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-2578
Practice Address - Country:US
Practice Address - Phone:786-877-6923
Practice Address - Fax:305-222-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8990111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH8990OtherLIC