Healthcare Provider Details

I. General information

NPI: 1801952304
Provider Name (Legal Business Name): PAUL HERMAN DCPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9469 SHERIDAN STREET
COOPER CITY FL
33024
US

IV. Provider business mailing address

9469 SHERIDAN STREET
COOPER CITY FL
33024
US

V. Phone/Fax

Practice location:
  • Phone: 954-432-5775
  • Fax: 954-432-2525
Mailing address:
  • Phone: 954-432-5775
  • Fax: 954-432-2525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH7496
License Number StateFL

VIII. Authorized Official

Name: DR. PAUL HERMAN
Title or Position: DOCTOR
Credential: DC
Phone: 954-432-5775