Provider Demographics
NPI:1215284484
Name:BRAIN TRAIN CENTER INC
Entity type:Organization
Organization Name:BRAIN TRAIN CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:281-414-6573
Mailing Address - Street 1:3245 VIRGINIA ST
Mailing Address - Street 2:21
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-5229
Mailing Address - Country:US
Mailing Address - Phone:281-414-6573
Mailing Address - Fax:
Practice Address - Street 1:3245 VIRGINIA ST
Practice Address - Street 2:21
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-5229
Practice Address - Country:US
Practice Address - Phone:281-414-6573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10490111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty