Provider Demographics
NPI:1336362540
Name:SIEGLER, RICHARD N (DC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:N
Last Name:SIEGLER
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 1:2440 NE MIAMI GARDENS DRIVE
Mailing Address - Street 2:SUITE #101
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180
Mailing Address - Country:US
Mailing Address - Phone:305-705-0777
Mailing Address - Fax:305-705-9978
Practice Address - Street 1:2440 NE MIAMI GARDENS DRIVE
Practice Address - Street 2:SUITE #101
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180
Practice Address - Country:US
Practice Address - Phone:305-705-0777
Practice Address - Fax:305-705-9978
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 4823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70505Medicare ID - Type Unspecified