=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568586865
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DOCTORS CHIROPRACTIC CENTER INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/19/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8043 W OAKLAND PARK BLVD
-----------------------------------------------------
City | SUNRISE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33351-1116
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-742-7066
-----------------------------------------------------
Fax | 954-741-9507
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8697 BOCA GLADES BLVD W APT C
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33434-4099
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-451-4545
-----------------------------------------------------
Fax | 561-558-1085
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT-OWNER
-----------------------------------------------------
Name | MR. BERNARD DOLBERG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 561-451-4545
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH2892
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------