Healthcare Provider Details

I. General information

NPI: 1295660611
Provider Name (Legal Business Name): DYLAN JOHN CHRUMA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9960 CENTRAL PARK BLVD N STE 400
BOCA RATON FL
33428-1705
US

IV. Provider business mailing address

1717 N BAYSHORE DR APT 3355
MIAMI FL
33132-1168
US

V. Phone/Fax

Practice location:
  • Phone: 561-470-5437
  • Fax:
Mailing address:
  • Phone: 516-419-2313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: