Provider Demographics
NPI:1730395518
Name:CORRECT CARE MEDICAL INC
Entity type:Organization
Organization Name:CORRECT CARE MEDICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-753-3992
Mailing Address - Street 1:9838 WEST SAMPLE ROAD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4006
Mailing Address - Country:US
Mailing Address - Phone:954-753-3992
Mailing Address - Fax:954-753-9348
Practice Address - Street 1:9838 WEST SAMPLE ROAD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4006
Practice Address - Country:US
Practice Address - Phone:954-753-3992
Practice Address - Fax:954-753-9348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6239111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1255395422OtherINDIVIDUAL NPI
450130Medicare UPIN
FL22526ZMedicare ID - Type Unspecified