Provider Demographics
NPI:1356467757
Name:BRECHER, MATTHEW U (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:U
Last Name:BRECHER
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 1:4015 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-1001
Mailing Address - Country:US
Mailing Address - Phone:813-933-5259
Mailing Address - Fax:813-935-3698
Practice Address - Street 1:4015 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1001
Practice Address - Country:US
Practice Address - Phone:813-933-5259
Practice Address - Fax:813-935-3698
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007261111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3815765 00Medicaid
FLU79470Medicare UPIN
55553ZMedicare ID - Type Unspecified