Healthcare Provider Details

I. General information

NPI: 1396888525
Provider Name (Legal Business Name): BRIAN RAPPAPORT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7410 BOYNTON BEACH BLVD SUITE B5
BOYNTON BEACH FL
33437-6156
US

IV. Provider business mailing address

7410 BOYNTON BEACH BLVD SUITE B5
BOYNTON BEACH FL
33437-6156
US

V. Phone/Fax

Practice location:
  • Phone: 561-369-0808
  • Fax: 561-374-7448
Mailing address:
  • Phone: 561-369-0808
  • Fax: 561-374-7448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7857
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: