Healthcare Provider Details

I. General information

NPI: 1104019959
Provider Name (Legal Business Name): BRUCE SCOTT HORNFELD D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 08/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1893 NE 164TH ST #100
NORTH MIAMI BEACH FL
33162-4168
US

IV. Provider business mailing address

PO BOX 550224
FT LAUDERDALE FL
33355-0224
US

V. Phone/Fax

Practice location:
  • Phone: 954-646-6942
  • Fax: 954-476-8153
Mailing address:
  • Phone: 954-646-6942
  • Fax: 954-476-8153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberCH0007013
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: