Organization
CHIROPRACTIC BACK PAIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OCTAVIO P. FERNANDEZ D.C. (PRESIDENT)
(305) 774-6923
Entity
Organization
Contact information
Practice address
2645 SW 37TH AVE, SUITE 704, MIAMI, FL 33133-2754
(305) 774-1119
(305) 774-1141
Mailing address
1029 MALAGA AVE, CORAL GABLES, FL 33134-6318
(305) 448-8251
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH6723
FL
Other
Enumeration date
11/14/2006
Last updated
08/22/2020
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