Coconut Grove Chiropractic, Inc

Organization Active NPI Chiropractor · Coconut Grove, FL

NPI 1962695387 · NPPES record last updated Aug 20, 2007

Key facts

NPI
1962695387
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
License
CH7418 (FL)
Legal business name
COCONUT GROVE CHIROPRACTIC, INC
Practice address
3151 SW 27TH Ave
Coconut Grove, FL 33133-4634
Phone
(305) 443-4636
Fax
(305) 442-4641
NPI assigned
Aug 20, 2007
Organization subpart
No

Authorized official

Name
Dr. Eduardo A. Martinez, D.C.
Title
P/V/T/S
Phone
(305) 443-4636

Practitioners 2

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20051121000334 FL Part B Supplier - Clinic/Group Practice 7911926860 Receives reassigned benefits from 2 practitioners
Practice locations: Miami, FL

National Provider Directory

Locations

3400 Coral Way
Ste 101
Miami, FL 33145
Phone (305) 443-4636

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X CH7418 FL Yes

Addresses

Primary practice location

3151 SW 27TH Ave
Coconut Grove, FL 33133-4634

Mailing address

3151 SW 27TH Ave
Coconut Grove, FL 33133-4634
Phone (305) 443-4636

Other providers in Coconut Grove, FL

All providers in Coconut Grove, FL · Chiropractor in Florida

Sources for this page

Verify at the official NPI Registry.