Provider Demographics
NPI:1750447538
Name:BURTON, BERNARD S (DC)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:S
Last Name:BURTON
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 1:7800 W OAKLAND PARK BLVD BLDG D STE 110
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-1122
Mailing Address - Country:US
Mailing Address - Phone:954-742-0332
Mailing Address - Fax:954-742-7344
Practice Address - Street 1:7800 W OAKLAND PARK BLVD BLDG D STE 110
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351
Practice Address - Country:US
Practice Address - Phone:954-742-0332
Practice Address - Fax:954-742-7344
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 6885111N00000X
FLCH0006885111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0005120284OtherAETNA
FL380-851-300Medicaid
FL55219OtherBLUE CROSS BLUE SHIELD
FL55219OtherBLUE CROSS BLUE SHIELD