Provider Demographics
NPI:1043341084
Name:RUKEYSER, DANIEL AARON (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:AARON
Last Name:RUKEYSER
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 1:1555 SW PENDARVIS CT
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-4501
Mailing Address - Country:US
Mailing Address - Phone:561-602-6198
Mailing Address - Fax:772-232-4092
Practice Address - Street 1:3543 SW CORPORATE PKWY
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-8151
Practice Address - Country:US
Practice Address - Phone:772-334-1773
Practice Address - Fax:772-334-4997
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8946111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL382241900Medicaid
FL70290OtherBLUE CROSS BLUE SHIELD
FL70290ZMedicare ID - Type Unspecified