Provider Demographics
NPI:1336318427
Name:HEBAUF, BROOKE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:MARIE
Last Name:HEBAUF
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 1:3612 S DALE MABRY HWY STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-8657
Mailing Address - Country:US
Mailing Address - Phone:813-374-0116
Mailing Address - Fax:813-443-4875
Practice Address - Street 1:3612 S DALE MABRY HWY STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-8657
Practice Address - Country:US
Practice Address - Phone:813-374-0116
Practice Address - Fax:813-443-4875
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9477111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor