Provider Demographics
NPI:1497756548
Name:ESTRIN, SETH HOWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:HOWARD
Last Name:ESTRIN
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 1:5799 PADDINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2513
Mailing Address - Country:US
Mailing Address - Phone:561-998-0510
Mailing Address - Fax:561-998-0163
Practice Address - Street 1:5030 CHAMPION BLVD
Practice Address - Street 2:SUITE G-9
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2473
Practice Address - Country:US
Practice Address - Phone:561-998-0510
Practice Address - Fax:561-998-0163
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007633111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55801OtherBLUE CROSS/BLUE SHIELD
FL55801ZMedicare ID - Type Unspecified
FLU75383Medicare UPIN