Provider Demographics
NPI:1215511258
Name:BOCA CHIROPRACTIC SPINE AND WELLNESS LLC
Entity type:Organization
Organization Name:BOCA CHIROPRACTIC SPINE AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ACONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-727-6869
Mailing Address - Street 1:2499 GLADES RD STE 303
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7202
Mailing Address - Country:US
Mailing Address - Phone:561-479-2880
Mailing Address - Fax:
Practice Address - Street 1:2499 GLADES RD STE 303
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7202
Practice Address - Country:US
Practice Address - Phone:561-479-2880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1346683711OtherNPI