Provider Demographics
NPI:1336357409
Name:BRAUN, SCOTT R (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:R
Last Name:BRAUN
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 1:18300 CLEAR BROOK CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-1947
Mailing Address - Country:US
Mailing Address - Phone:561-305-4468
Mailing Address - Fax:561-852-2034
Practice Address - Street 1:18300 CLEAR BROOK CIR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-1947
Practice Address - Country:US
Practice Address - Phone:561-305-4468
Practice Address - Fax:561-852-2034
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007601111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL83963Medicare PIN