Provider Demographics
NPI:1811945371
Name:DRESNER, DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:DRESNER
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 1:13889 WELLINGTON TRCE
Mailing Address - Street 2:SUITE A-3
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-2121
Mailing Address - Country:US
Mailing Address - Phone:561-798-9778
Mailing Address - Fax:561-798-0563
Practice Address - Street 1:13889 WELLINGTON TRCE
Practice Address - Street 2:SUITE A-3
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-2121
Practice Address - Country:US
Practice Address - Phone:561-798-9778
Practice Address - Fax:561-798-0563
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7054111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381603600Medicaid
FL381603600Medicaid
FL55359Medicare ID - Type UnspecifiedMEDICARE