Provider Demographics
NPI:1851596027
Name:FARNEY, BRAD L (DC)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:L
Last Name:FARNEY
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 1:1051 PORT MALABAR BLVD NE STE 2
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-5153
Mailing Address - Country:US
Mailing Address - Phone:321-960-6467
Mailing Address - Fax:
Practice Address - Street 1:1421 MALABAR RD NE
Practice Address - Street 2:SUITE 200
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-2576
Practice Address - Country:US
Practice Address - Phone:321-308-2660
Practice Address - Fax:321-984-9303
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9390111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNS177OtherMEDICARE HF