Provider Demographics
NPI:1376918847
Name:BERNARD EPSTEIN D.C.
Entity Type:Organization
Organization Name:BERNARD EPSTEIN D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:321-777-0470
Mailing Address - Street 1:2000 S COURTENAY PKWY
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-3912
Mailing Address - Country:US
Mailing Address - Phone:321-452-1702
Mailing Address - Fax:321-777-0479
Practice Address - Street 1:1357 HIGHWAY A1A
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-2407
Practice Address - Country:US
Practice Address - Phone:321-777-0470
Practice Address - Fax:321-777-0479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH1275111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT55732Medicare UPIN
FL88184AMedicare PIN