Provider Demographics
NPI:1073861407
Name:FEIN, BUDDY H (DC)
Entity Type:Individual
Prefix:DR
First Name:BUDDY
Middle Name:H
Last Name:FEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:BUD
Other - Middle Name:H
Other - Last Name:FEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4705 WOODLANDS BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-3510
Mailing Address - Country:US
Mailing Address - Phone:954-931-3659
Mailing Address - Fax:954-533-5511
Practice Address - Street 1:4705 WOODLANDS BLVD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-3510
Practice Address - Country:US
Practice Address - Phone:954-931-3659
Practice Address - Fax:954-533-5511
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3645111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor