Provider Demographics
NPI:1396314472
Name:TAMIAMI CHIROPRACTIC INJURY CLINIC LLC
Entity type:Organization
Organization Name:TAMIAMI CHIROPRACTIC INJURY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTELLANOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:786-351-4429
Mailing Address - Street 1:6373 SW 32ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3036
Mailing Address - Country:US
Mailing Address - Phone:786-351-4429
Mailing Address - Fax:
Practice Address - Street 1:6373 SW 32ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3036
Practice Address - Country:US
Practice Address - Phone:786-351-4429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty