Provider Demographics
NPI:1205563756
Name:FUERZA CHIROPRACTIC LLC
Entity type:Organization
Organization Name:FUERZA CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:RAUL
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-673-6001
Mailing Address - Street 1:401 N ROME AVE APT 4306
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-0050
Mailing Address - Country:US
Mailing Address - Phone:787-673-6001
Mailing Address - Fax:
Practice Address - Street 1:5411 BEAUMONT CENTER BLVD STE 795
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-5227
Practice Address - Country:US
Practice Address - Phone:787-673-6001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty