Revive Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

REVIVE CHIROPRACTIC LLC

Practice address

18249 Pines Blvd
Pembroke Pines, FL 33029-1418

Phone

(754) 779-4527

NPI assigned

Jul 12, 2018

Organization subpart

No

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

Authorized official

Name

Alfonso Chie, DC

Title

Doctor/Owner

Phone

(754) 779-4527

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565136000000",
    "number": "1255817342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18249 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291418",
            "telephone_number": "754-779-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18249 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291418",
            "telephone_number": "754-779-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-12",
        "last_updated": "2019-08-07",
        "status": "A",
        "authorized_official_last_name": "CHIE",
        "authorized_official_first_name": "ALFONSO",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "754-779-4527",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Aug 7, 2019; 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.