Provider Demographics
NPI:1992948517
Name:CHIROPRACTIC CARE OF PALM BEACH INC
Entity type:Organization
Organization Name:CHIROPRACTIC CARE OF PALM BEACH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXI
Authorized Official - Middle Name:OMID
Authorized Official - Last Name:FAKHARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-833-7141
Mailing Address - Street 1:50 COCOANUT ROW
Mailing Address - Street 2:STE 215
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-4025
Mailing Address - Country:US
Mailing Address - Phone:561-833-7141
Mailing Address - Fax:561-833-7041
Practice Address - Street 1:50 COCOANUT ROW
Practice Address - Street 2:STE 215
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-4025
Practice Address - Country:US
Practice Address - Phone:561-833-7141
Practice Address - Fax:561-833-7041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty