1174126361 NPI number — FIERMAN FAMILY CHIROPRACTIC, LLC

Table of content: (NPI 1174126361)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174126361 NPI number — FIERMAN FAMILY CHIROPRACTIC, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FIERMAN FAMILY CHIROPRACTIC, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174126361
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8058 TUMBLESTONE CT APT 126
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DELRAY BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33446-4431
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-404-0030
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4400 N. FEDERAL HIGHWAY 210-37
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOCA RATON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33431-4471
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-867-8114
Provider Business Practice Location Address Fax Number:
561-486-5092
Provider Enumeration Date:
11/19/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FIERMAN
Authorized Official First Name:
LINDSAY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
239-404-0030

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1447757513 . This is a "NPI NUMBER" identifier . This identifiers is of the category "OTHER".