Provider Demographics
NPI:1619086774
Name:OKMAN, CLIFTON DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:CLIFTON
Middle Name:DAVID
Last Name:OKMAN
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 1:7244 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-1041
Mailing Address - Country:US
Mailing Address - Phone:954-748-5500
Mailing Address - Fax:954-748-7500
Practice Address - Street 1:7244 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-1041
Practice Address - Country:US
Practice Address - Phone:954-748-5500
Practice Address - Fax:954-748-7500
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4184111NS0005X
COCH4014111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380981100Medicaid
FL88049Medicare ID - Type Unspecified
FLT55661Medicare UPIN