Provider Demographics
NPI:1942243886
Name:JANKE, BRUCE E (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:E
Last Name:JANKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 E SAMPLE RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6242
Mailing Address - Country:US
Mailing Address - Phone:954-942-4433
Mailing Address - Fax:954-942-0448
Practice Address - Street 1:1201 E SAMPLE RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-6242
Practice Address - Country:US
Practice Address - Phone:954-942-4433
Practice Address - Fax:954-942-0448
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0074452174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023410OtherNEIGHBORHOOD HMO
FLME 0074452OtherWORKERS COMPENSATION
FL65-0834146OtherORTHOPEDIX NETWORK HMO
FL42424OtherBS OF FL HEALTH OPTIONS
FL65-1039722OtherHUMANA
FL2145973OtherAETNA
FLBJ4953003OtherDEA
FL65-1039722OtherHUMANA
FLF74091Medicare UPIN