Provider Demographics
NPI:1487849469
Name:ROPER, KEEGAN JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:KEEGAN
Middle Name:JAMES
Last Name:ROPER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 E OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1677
Mailing Address - Country:US
Mailing Address - Phone:954-491-4437
Mailing Address - Fax:954-491-4492
Practice Address - Street 1:2740 E OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1677
Practice Address - Country:US
Practice Address - Phone:954-491-4437
Practice Address - Fax:954-491-4492
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8538111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88180OtherBCBS