| Jireh Provisions Fl I | |
|
11011 Sheridan St Ste 214, Hollywood, FL 33026-1531 | |
| (954) 680-8182 | |
| (954) 680-8184 |
| Full Name | Jireh Provisions Fl I |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 11011 Sheridan St Ste 214, Hollywood, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609509520 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Cecil Pardave |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1134858863 PECOS PAC ID: 6507234713 Enrollment ID: I20221119000011 |
| Mailing Address | Practice Location Address |
|---|---|
| Jireh Provisions Fl I 11011 Sheridan St Ste 214, Hollywood, FL 33026-1531 Ph: (954) 680-8182 | Jireh Provisions Fl I 11011 Sheridan St Ste 214, Hollywood, FL 33026-1531 Ph: (954) 680-8182 |
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