MEDICARE: RONALD B FELDMAN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NS0005X	Sports Physician Chiropractor	CH0003988	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003877556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD B FELDMAN D.C.

Provider Business Mailing Address
First Line	:	8287 N PINE ISLAND RD
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-1541
Country	:	US
Telephone Number	:	954-722-6637
Fax Number	:	954-720-6298

Provider Business Practice Location Address
First Line	:	8287 N PINE ISLAND RD
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-1541
Country	:	US
Telephone Number	:	954-722-6637
Fax Number	:	954-720-6298

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	07/28/2010

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