Chiropractic Back Pain Clinic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH6723 Issued in FL

Legal business name

CHIROPRACTIC BACK PAIN CLINIC

Practice address

2645 SW 37TH Ave
Suite 704
Miami, FL 33133-2754

Phone

(305) 774-1119

Fax

(305) 774-1141

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Octavio P. Fernandez, D.C.

Title

President

Phone

(305) 774-6923

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437221819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 MALAGA AVE",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331346318",
            "telephone_number": "305-448-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 SW 37TH AVE",
            "address_2": "SUITE 704",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331332754",
            "telephone_number": "305-774-1119",
            "fax_number": "305-774-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC BACK PAIN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "OCTAVIO",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-774-6923",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6723",
            "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 22, 2020; 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.