Organization
IMAC MANAGEMENT OF FLORIDA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF ERVIN CEO (CHIEF EXECUTIVE OFFICER)
(615) 889-0024
Entity
Organization
Contact information
Practice address
24830 S TAMIAMI TRL STE 1000, BONITA SPRINGS, FL 34134-7031
(239) 948-3280
(239) 236-1719
Mailing address
1605 WESTGATE CIR STE 100, BRENTWOOD, TN 37027-8396
(615) 889-0024
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH7358
STATE CHIROPRACTIC LICENSE
FL
Enumeration date
01/15/2020
Last updated
01/15/2020
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