Healthcare Provider Details

I. General information

NPI: 1083808596
Provider Name (Legal Business Name): DAVID EVAN YACHTER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10189 CLEARY BLVD SUITE103
PLANTATION FL
33324-1027
US

IV. Provider business mailing address

10189 CLEARY BLVD SUITE103
PLANTATION FL
33324-1027
US

V. Phone/Fax

Practice location:
  • Phone: 954-472-6002
  • Fax: 954-472-7111
Mailing address:
  • Phone: 954-472-6002
  • Fax: 954-472-7111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0006780
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH6780
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: