Healthcare Provider Details

I. General information

NPI: 1275993669
Provider Name (Legal Business Name): BINYAMIN SUSSMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BINYAMIN RUBINSTEIN DC

II. Dates (important events)

Enumeration Date: 02/29/2016
Last Update Date: 02/13/2020
Certification Date: 02/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6245 N FEDERAL HWY STE 405
FT LAUDERDALE FL
33308-1998
US

IV. Provider business mailing address

6245 N FEDERAL HWY STE 405
FT LAUDERDALE FL
33308-1998
US

V. Phone/Fax

Practice location:
  • Phone: 866-305-6468
  • Fax: 866-805-6466
Mailing address:
  • Phone: 866-305-6468
  • Fax: 866-805-6466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH11589
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: