Provider Demographics
NPI:1912575291
Name:OCEAN HEALTH CENTER
Entity Type:Organization
Organization Name:OCEAN HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FACKLER
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:954-817-3635
Mailing Address - Street 1:3301 NE 32ND AVE APT 403
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-7121
Mailing Address - Country:US
Mailing Address - Phone:954-817-3635
Mailing Address - Fax:954-686-8806
Practice Address - Street 1:1348 SE 17TH ST
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1708
Practice Address - Country:US
Practice Address - Phone:954-817-3635
Practice Address - Fax:954-686-8806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty