Provider Demographics
NPI:1649649112
Name:ELEVATION HEALTH-MIAMI
Entity type:Organization
Organization Name:ELEVATION HEALTH-MIAMI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:YACHTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-472-6002
Mailing Address - Street 1:18300 NW 62ND AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33015-8200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18300 NW 62ND AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-8200
Practice Address - Country:US
Practice Address - Phone:305-705-3166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELEVATION HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10668111N00000X
FLCH6780111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty