Provider Demographics
NPI:1396888525
Name:RAPPAPORT, BRIAN (DC)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:RAPPAPORT
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 1:7410 BOYNTON BEACH BLVD
Mailing Address - Street 2:SUITE B5
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-6156
Mailing Address - Country:US
Mailing Address - Phone:561-369-0808
Mailing Address - Fax:561-374-7448
Practice Address - Street 1:7410 BOYNTON BEACH BLVD
Practice Address - Street 2:SUITE B5
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-6156
Practice Address - Country:US
Practice Address - Phone:561-369-0808
Practice Address - Fax:561-374-7448
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL60002OtherBCBS
FL7857OtherFLORIDA LICENSE NUMBER
FL7857OtherFLORIDA LICENSE NUMBER
FLU81063Medicare UPIN