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General NPI Number Information
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NPI Number | 1457423741
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Entity Type | Individual
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Provider Name | JEFFREY S. TARTACK DC
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Gender | Male
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 12/08/2014
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Provider Practice Location Address
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Address Line | 1222 S ANDREWS AVE SUITE 501
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-1806
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Country | US
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Telephone | 954-764-4042
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Fax | 954-764-7275
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Provider Business Mailing Address
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Address Line | 1222 S ANDREWS AVE SUITE 501
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-1806
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Country | US
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Telephone | 954-764-4042
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Fax | 954-764-7275
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH0008769
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License Number State | FL
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