Healthcare Provider Details

I. General information

NPI: 1467758383
Provider Name (Legal Business Name): DEAN L FISHMAN D.C., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2011
Last Update Date: 04/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 N UNIVERSITY DR
PLANTATION FL
33322-4111
US

IV. Provider business mailing address

1751 N UNIVERSITY DR
PLANTATION FL
33322-4111
US

V. Phone/Fax

Practice location:
  • Phone: 954-577-6161
  • Fax: 954-577-4447
Mailing address:
  • Phone: 954-577-6161
  • Fax: 954-577-4447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DEAN L FISHMAN
Title or Position: DIRECTOR
Credential: D.C.
Phone: 954-577-6161