Provider Demographics
NPI:1922065390
Name:HEDGLON, PAULA R (DC)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:R
Last Name:HEDGLON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 E SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6244
Mailing Address - Country:US
Mailing Address - Phone:954-946-1799
Mailing Address - Fax:954-946-7801
Practice Address - Street 1:1313 E SAMPLE RD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-6244
Practice Address - Country:US
Practice Address - Phone:954-946-1799
Practice Address - Fax:954-946-7801
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22225111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL051191900Medicaid
FL22225OtherBLUE CROSS BLUE SHIELD
FL0399334000OtherAMERIHEALTH
FL0399334000OtherAMERIHEALTH
FL22225OtherBLUE CROSS BLUE SHIELD