Provider Demographics
NPI:1093711400
Name:HANOPOLE, ROBERT J (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:HANOPOLE
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 1:8320 W SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-5435
Mailing Address - Country:US
Mailing Address - Phone:954-423-0020
Mailing Address - Fax:954-423-3091
Practice Address - Street 1:8320 W SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5435
Practice Address - Country:US
Practice Address - Phone:954-423-0020
Practice Address - Fax:954-423-3091
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2009-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6895111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55297OtherBLUE CROSS BLUE SHIELD
FL55297YMedicare PIN
U56305Medicare UPIN