Provider Demographics
NPI:1396783361
Name:EXCELLENT CARE CHIROPRACTIC CENTER, INC
Entity type:Organization
Organization Name:EXCELLENT CARE CHIROPRACTIC CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ORLAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-871-9087
Mailing Address - Street 1:6595 NW 36TH ST
Mailing Address - Street 2:SUITE 304 2
Mailing Address - City:VIRGINIA GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6979
Mailing Address - Country:US
Mailing Address - Phone:305-871-9087
Mailing Address - Fax:305-871-9097
Practice Address - Street 1:6595 NW 36TH ST
Practice Address - Street 2:SUITE 304 2
Practice Address - City:VIRGINIA GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33166-6979
Practice Address - Country:US
Practice Address - Phone:305-871-9087
Practice Address - Fax:305-871-9097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5125261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC5125OtherHEALTH CARE CLINIC
FLHCC5125OtherHEALTH CARE CLINIC