Provider Demographics
NPI:1447681002
Name:RED BIRD CHIROPRACTIC, PA
Entity type:Organization
Organization Name:RED BIRD CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HERMANN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-606-4433
Mailing Address - Street 1:5761 BIRD RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5336
Mailing Address - Country:US
Mailing Address - Phone:305-763-8880
Mailing Address - Fax:305-763-8166
Practice Address - Street 1:5761 BIRD RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-5336
Practice Address - Country:US
Practice Address - Phone:305-763-8880
Practice Address - Fax:305-763-8166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7483111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty