NPIMap

Organization Active NPI

Sunrise Physical Medicine and Wellness Center, Inc.

  • Chiropractor
  • Sunrise, FL
National Provider Identifier
1043323298
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0004066 Issued in FL
Legal business name
SUNRISE PHYSICAL MEDICINE AND WELLNESS CENTER, INC.
Practice address
4507 N Pine Island Rd
Sunrise, FL 33351-5321
Phone
(954) 741-6233
Fax
(954) 742-0583
NPI assigned
Aug 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Howard Shtulman, D.C.
Title
President
Phone
(954) 741-6233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH0004066 FL Primary

Addresses

Primary practice location

4507 N Pine Island Rd
Sunrise, FL 33351-5321

Mailing address

4507 N Pine Island Rd
Sunrise, FL 33351-5321
Phone (954) 741-6233

National Provider Directory

National Provider Directory

Locations

1879 Portola Rd
Ste A2
Ventura, CA 93003
Phone (805) 644-1273

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 25

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1043323298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4507 N PINE ISLAND RD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333515321",
            "telephone_number": "954-741-6233",
            "fax_number": "954-742-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4507 N PINE ISLAND RD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333515321",
            "telephone_number": "954-741-6233",
            "fax_number": "954-742-0583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE PHYSICAL MEDICINE AND WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "SHTULMAN",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-741-6233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0004066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.