1649300997 NPI number — SOUTH FLORIDA CHIROPRACTIC CENTERS, INC

Table of content: MS. NANCY ANN CRUMMEL FNP (NPI 1922003367)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649300997 NPI number — SOUTH FLORIDA CHIROPRACTIC CENTERS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH FLORIDA CHIROPRACTIC CENTERS, INC
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:
1649300997
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/01/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12673 SOUTH DIXIE HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33156
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-242-6460
Provider Business Mailing Address Fax Number:
786-242-6430

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12673 SOUTH DIXIE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33156
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-242-6460
Provider Business Practice Location Address Fax Number:
786-242-6430
Provider Enumeration Date:
03/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PETRILLO
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OWNER DOCTOR
Authorized Official Telephone Number:
786-242-6460

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)





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