MEDICARE: VICTOR J DROBNIC D.C. P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH003546	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K3702	OTHER	FL	MEDICARE GROUP

General Provider Information

NPI Number	:	1174799175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VICTOR J DROBNIC D.C. P.A.

Provider Business Mailing Address
First Line	:	1646 COLONIAL BLVD
Second Line	:	SUITE 1
City	:	FORT MYERS
State	:	FL
Zip	:	33907
Country	:	US
Telephone Number	:	239-936-2911
Fax Number	:	239-936-2811

Provider Business Practice Location Address
First Line	:	1646 COLONIAL BLVD
Second Line	:	SUITE 1
City	:	FORT MYERS
State	:	FL
Zip	:	33907
Country	:	US
Telephone Number	:	239-936-2911
Fax Number	:	239-936-2811

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VICTOR J DROBNIC
Credential	:	D.C. P.A.
Telephone Number	:	239-936-2911

Provider Enumeration Date	:	04/30/2008
Last Update Date	:	02/20/2012

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