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NPI Code Detail

MEDICARE: DR. HARRY G MIKAZANS DC

MEDICARE: DR. HARRY G MIKAZANS DC
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
1111NS0005XSports Physician ChiropractorCH0006645FL

General Provider Information

NPI Number : 1396730214
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HARRY G MIKAZANS DC
Provider Business Mailing Address
First Line : 1000 E HILLSBORO BLVD
Second Line : SUITE 104
City : DEERFIELD BEACH
State : FL
Zip : 33441-3628
Country : US
Telephone Number : 954-363-7494
Fax Number : 954-363-7497
Provider Business Practice Location Address
First Line : 1000 E HILLSBORO BLVD
Second Line : SUITE 104
City : DEERFIELD BEACH
State : FL
Zip : 33441-3628
Country : US
Telephone Number : 954-363-7494
Fax Number : 954-363-7497
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2005
Last Update Date : 05/22/2014

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