Provider Demographics
NPI:1124223748
Name:DRANE, CORNELIOUS JR (AP)
Entity Type:Individual
Prefix:DR
First Name:CORNELIOUS
Middle Name:
Last Name:DRANE
Suffix:JR
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 SW 137TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3206
Mailing Address - Country:US
Mailing Address - Phone:786-426-8076
Mailing Address - Fax:954-322-1113
Practice Address - Street 1:6517 TAFT ST STE 200
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-4048
Practice Address - Country:US
Practice Address - Phone:954-967-1100
Practice Address - Fax:954-967-2600
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2387171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist