Provider Demographics
NPI:1912265307
Name:MCNAMARA CHIROPRACTIC CENTER, P.A.
Entity Type:Organization
Organization Name:MCNAMARA CHIROPRACTIC CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:MCNAMARA
Authorized Official - Last Name:KRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-943-1100
Mailing Address - Street 1:3320 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6742
Mailing Address - Country:US
Mailing Address - Phone:954-943-1100
Mailing Address - Fax:954-943-9226
Practice Address - Street 1:3320 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-6742
Practice Address - Country:US
Practice Address - Phone:954-943-1100
Practice Address - Fax:954-943-9226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70863OtherBLUE CROSS AND BLUE SHIELD
FL380434800Medicaid
FL70863OtherBLUE CROSS AND BLUE SHIELD
FL380434800Medicaid