Provider Demographics
NPI:1477574556
Name:DANDYL HEALTHCARE PA
Entity Type:Organization
Organization Name:DANDYL HEALTHCARE PA
Other - Org Name:UNIVERSITY HEALTH CENTER DBA DR STEVEN CANE DR DIEGO KUSTLER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:CANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-722-6050
Mailing Address - Street 1:7797 N UNIVERSITY DR
Mailing Address - Street 2:#101
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321
Mailing Address - Country:US
Mailing Address - Phone:954-722-6050
Mailing Address - Fax:954-720-7776
Practice Address - Street 1:7797 N UNIVERSITY DR
Practice Address - Street 2:#101
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321
Practice Address - Country:US
Practice Address - Phone:954-722-6050
Practice Address - Fax:954-720-7776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6266111N00000X
FLCH8420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty