Provider Demographics
NPI:1003933615
Name:FINE, JAMIE ALLEN (DC)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:ALLEN
Last Name:FINE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4651 SHERIDAN STREET
Mailing Address - Street 2:SUITE 220
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021
Mailing Address - Country:US
Mailing Address - Phone:954-965-0421
Mailing Address - Fax:
Practice Address - Street 1:4651 SHERIDAN ST
Practice Address - Street 2:SUITE 220
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3457
Practice Address - Country:US
Practice Address - Phone:954-965-0421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7528111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor