Provider Demographics
NPI:1992458699
Name:SOUTH FLORIDA SPINE AND CHIROPRACTIC CENTERS, LLC
Entity type:Organization
Organization Name:SOUTH FLORIDA SPINE AND CHIROPRACTIC CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:L
Authorized Official - Last Name:WESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-913-4496
Mailing Address - Street 1:8958 W. STATE ROAD 84
Mailing Address - Street 2:PMB #179
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324
Mailing Address - Country:US
Mailing Address - Phone:954-913-4496
Mailing Address - Fax:954-769-1970
Practice Address - Street 1:3111 N UNIVERSITY DR STE 402
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5033
Practice Address - Country:US
Practice Address - Phone:954-913-4496
Practice Address - Fax:954-769-1970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1982681052OtherNPI NUMBER