Provider Demographics
NPI:1033224548
Name:STANGER, JEFFREY L (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:L
Last Name:STANGER
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 1:601 N CONGRESS AVE
Mailing Address - Street 2:SUITE 417
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4621
Mailing Address - Country:US
Mailing Address - Phone:561-498-4300
Mailing Address - Fax:561-498-4539
Practice Address - Street 1:601 N CONGRESS AVE
Practice Address - Street 2:SUITE 417
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4621
Practice Address - Country:US
Practice Address - Phone:561-498-4300
Practice Address - Fax:561-498-4539
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3463111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL051002500Medicaid
FL88586OtherBCBS
FL88586OtherBCBS
FL051002500Medicaid