Provider Demographics
NPI:1891818266
Name:PEMBROKE PINES ACCIDENT & INJURY CENTER, INC.
Entity Type:Organization
Organization Name:PEMBROKE PINES ACCIDENT & INJURY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:B
Authorized Official - Last Name:SENTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-931-2312
Mailing Address - Street 1:949 TANGLEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1846
Mailing Address - Country:US
Mailing Address - Phone:954-931-2312
Mailing Address - Fax:954-252-4112
Practice Address - Street 1:1633 N HIATUS RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-2129
Practice Address - Country:US
Practice Address - Phone:954-931-2312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8141111N00000X
FLCH8100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty