Provider Demographics
NPI:1003877556
Name:FELDMAN, RONALD B (DC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:B
Last Name:FELDMAN
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 1:8287 N PINE ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-1541
Mailing Address - Country:US
Mailing Address - Phone:954-722-6637
Mailing Address - Fax:954-720-6298
Practice Address - Street 1:8287 N PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-1541
Practice Address - Country:US
Practice Address - Phone:954-722-6637
Practice Address - Fax:954-720-6298
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003988111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380109800Medicaid
FL88904Medicare ID - Type Unspecified
FLT56015Medicare UPIN