Provider Demographics
NPI:1346281854
Name:GREAUX, BERNARD ALEXANDER (DC)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:ALEXANDER
Last Name:GREAUX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:ALEXANDER
Other - Middle Name:
Other - Last Name:GREAUX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2440 NE MIAMI GARDENS DR
Mailing Address - Street 2:#101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2734
Mailing Address - Country:US
Mailing Address - Phone:305-705-0777
Mailing Address - Fax:305-705-9978
Practice Address - Street 1:2440 NE MIAMI GARDENS DR
Practice Address - Street 2:#101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-2734
Practice Address - Country:US
Practice Address - Phone:305-705-0777
Practice Address - Fax:305-705-9978
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8214111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU93029Medicare UPIN