Provider Demographics
NPI:1396761664
Name:MAROFSKY, STEPHEN R (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:R
Last Name:MAROFSKY
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 1:21088 LAS BRISAS CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-4820
Mailing Address - Country:US
Mailing Address - Phone:561-393-3815
Mailing Address - Fax:561-338-0580
Practice Address - Street 1:499 NE SPANISH RIVER BLVD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4536
Practice Address - Country:US
Practice Address - Phone:561-338-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6010111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22592OtherBC/BS I.D.#
FLU11082Medicare UPIN
FLK2608Medicare ID - Type UnspecifiedMEDICARE GROUP
FL22592OtherBC/BS I.D.#