Provider Demographics
NPI:1356100291
Name:GRTTD LLC DBA GRATITUDE CHIROPRACTIC
Entity type:Organization
Organization Name:GRTTD LLC DBA GRATITUDE CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCIDE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-204-9877
Mailing Address - Street 1:805 E BROWARD BLVD STE 301K
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2046
Mailing Address - Country:US
Mailing Address - Phone:305-204-9877
Mailing Address - Fax:
Practice Address - Street 1:805 E BROWARD BLVD STE 301K
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2046
Practice Address - Country:US
Practice Address - Phone:305-204-9877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center