Provider Demographics
NPI:1245420744
Name:BROWARD CHIROPRACTIC CENTER INC.
Entity Type:Organization
Organization Name:BROWARD CHIROPRACTIC CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:DRUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-486-1923
Mailing Address - Street 1:3601 W COMMERCIAL BLVD STE 11
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3335
Mailing Address - Country:US
Mailing Address - Phone:954-486-1923
Mailing Address - Fax:954-739-3072
Practice Address - Street 1:3601 W COMMERCIAL BLVD STE 11
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3335
Practice Address - Country:US
Practice Address - Phone:954-486-1923
Practice Address - Fax:954-739-3072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3128305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88820Medicare UPIN