Provider Demographics
NPI:1225160104
Name:J.R.P. DIAGNOSTICS & REHAB, INC
Entity Type:Organization
Organization Name:J.R.P. DIAGNOSTICS & REHAB, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:POPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-486-1377
Mailing Address - Street 1:4631 N.W. 31 AVE
Mailing Address - Street 2:#135
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309
Mailing Address - Country:US
Mailing Address - Phone:954-486-1377
Mailing Address - Fax:954-486-1374
Practice Address - Street 1:4384 N.W. 31 AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309
Practice Address - Country:US
Practice Address - Phone:954-486-1377
Practice Address - Fax:954-486-1374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDC 7081111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGL655AMedicare PIN