Provider Demographics
NPI:1366210759
Name:HEIBA, MUHAMMAD (DC)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:
Last Name:HEIBA
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 1:4402 MARTINIQUE CT APT D4
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33066-1425
Mailing Address - Country:US
Mailing Address - Phone:561-667-6237
Mailing Address - Fax:
Practice Address - Street 1:5975 N FEDERAL HWY STE 121
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-2661
Practice Address - Country:US
Practice Address - Phone:954-771-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor