Provider Demographics
NPI:1134496839
Name:JEFFREY T BERARD DC PA
Entity Type:Organization
Organization Name:JEFFREY T BERARD DC PA
Other - Org Name:D/B/A A BETTER LIFE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:T
Authorized Official - Last Name:BERARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-452-4600
Mailing Address - Street 1:286 S UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3341
Mailing Address - Country:US
Mailing Address - Phone:954-452-4600
Mailing Address - Fax:954-452-4652
Practice Address - Street 1:286 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3341
Practice Address - Country:US
Practice Address - Phone:954-452-4600
Practice Address - Fax:954-452-4652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-23
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGI488AMedicare PIN