Healthcare Provider Details

I. General information

NPI: 1194260372
Provider Name (Legal Business Name): BRODKIN CHIROPRACTIC AND ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2016
Last Update Date: 12/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7805 NW BEACON SQUARE BLVD SUITE 103
BOCA RATON FL
33487-1395
US

IV. Provider business mailing address

7805 NW BEACON SQUARE BLVD SUITE 103
BOCA RATON FL
33487-1395
US

V. Phone/Fax

Practice location:
  • Phone: 561-620-0174
  • Fax: 561-988-2125
Mailing address:
  • Phone: 561-620-0174
  • Fax: 561-988-2125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberCH4412
License Number StateFL

VIII. Authorized Official

Name: DR. RONALD A BRODKIN
Title or Position: CHIROPRACTIC NEUROLOGIST
Credential: DC,DIBCN,DIBE,FIACN
Phone: 561-620-0174