Provider Demographics
NPI:1043396542
Name:ABECKJERR, DANIEL A (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:ABECKJERR
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 1:177 NE 167TH STREET
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162
Mailing Address - Country:US
Mailing Address - Phone:305-651-8100
Mailing Address - Fax:305-651-2241
Practice Address - Street 1:177 NE 167TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3404
Practice Address - Country:US
Practice Address - Phone:305-651-8100
Practice Address - Fax:305-651-2241
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380081400Medicaid
FLT56047Medicare UPIN
FL88987Medicare ID - Type Unspecified