Provider Demographics
NPI:1235333253
Name:DVORKIN, EILEEN MARSHA (DC)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:MARSHA
Last Name:DVORKIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17230 WEST DIXIE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160
Mailing Address - Country:US
Mailing Address - Phone:305-948-9777
Mailing Address - Fax:305-948-3555
Practice Address - Street 1:17230 WEST DIXIE HIGHWAY
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160
Practice Address - Country:US
Practice Address - Phone:305-948-9777
Practice Address - Fax:305-948-3555
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2365111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
55567ZMedicare ID - Type Unspecified
U68337Medicare UPIN