Provider Demographics
NPI:1316229651
Name:BROFSKY, EVAN JUSTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:JUSTIN
Last Name:BROFSKY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:EVAN
Other - Middle Name:JUSTIN
Other - Last Name:BROFSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1410 S POWERLINE RD
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-4300
Mailing Address - Country:US
Mailing Address - Phone:954-772-2711
Mailing Address - Fax:
Practice Address - Street 1:1410 S POWERLINE RD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-4300
Practice Address - Country:US
Practice Address - Phone:954-772-2711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10362111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor