Provider Demographics
NPI:1578705836
Name:SAMBURSKY, BRUCE S (DC)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:S
Last Name:SAMBURSKY
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 1:12412 SAN JOSE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-8621
Mailing Address - Country:US
Mailing Address - Phone:904-683-4376
Mailing Address - Fax:904-683-4378
Practice Address - Street 1:12412 SAN JOSE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8621
Practice Address - Country:US
Practice Address - Phone:904-683-4376
Practice Address - Fax:904-683-4378
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9687111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor