Provider Demographics
NPI:1891521274
Name:THE EMERALD CHIROPRACTIC CO LLC
Entity type:Organization
Organization Name:THE EMERALD CHIROPRACTIC CO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-939-2200
Mailing Address - Street 1:8027 TWIN CEDER DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32583-2999
Mailing Address - Country:US
Mailing Address - Phone:850-939-2200
Mailing Address - Fax:
Practice Address - Street 1:9200 NAVARRE PKWY STE E
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-2977
Practice Address - Country:US
Practice Address - Phone:850-939-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty