Back Mastery Rehabilitation Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH9890 Issued in FL

Legal business name

BACK MASTERY REHABILITATION INC

Practice address

2261 N University Dr
Suite #101
Pembroke Pines, FL 33024-3623

Phone

(954) 322-8985

Fax

(954) 322-8981

NPI assigned

Mar 23, 2010

Organization subpart

No

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

Authorized official

Name

Carlos Carrazana, DC

Title

President

Phone

(954) 322-8985

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275609600000",
    "number": "1144544974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 N UNIVERSITY DR",
            "address_2": "SUITE #101",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243623",
            "telephone_number": "954-322-8985",
            "fax_number": "954-322-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2261 N UNIVERSITY DR",
            "address_2": "SUITE #101",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243623",
            "telephone_number": "954-322-8985",
            "fax_number": "954-322-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK MASTERY REHABILITATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-23",
        "last_updated": "2010-06-04",
        "status": "A",
        "authorized_official_last_name": "CARRAZANA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-322-8985",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9890",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME79915",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; 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.