Provider Demographics
NPI:1144499641
Name:SHAFF, ALAN MARTIN (DC)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:MARTIN
Last Name:SHAFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5255 MONTEREY CIRCLE
Mailing Address - Street 2:SUITE 69
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484
Mailing Address - Country:US
Mailing Address - Phone:561-271-4102
Mailing Address - Fax:561-638-2987
Practice Address - Street 1:1906 CLINT MOORE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2663
Practice Address - Country:US
Practice Address - Phone:561-271-4102
Practice Address - Fax:561-638-2987
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380949800Medicaid
FL380949800Medicaid
FL70670Medicare PIN