Provider Demographics
NPI:1891739256
Name:MINSKY, LEO ROY (DC)
Entity Type:Individual
Prefix:DR
First Name:LEO
Middle Name:ROY
Last Name:MINSKY
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 1:2501 W HILLSBORO BLVD
Mailing Address - Street 2:STE 107
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-8437
Mailing Address - Country:US
Mailing Address - Phone:954-421-1839
Mailing Address - Fax:954-698-9314
Practice Address - Street 1:1265 S MILITARY TRL
Practice Address - Street 2:SUITE 110
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-7688
Practice Address - Country:US
Practice Address - Phone:954-421-1839
Practice Address - Fax:954-698-9314
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4031111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70709Medicare ID - Type UnspecifiedMEDICARE
FLT85488Medicare UPIN