MEDICARE: DR. ADAM FACKLER DC

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	111N00000X	Chiropractor	CH1228	FL

General Provider Information

NPI Number	:	1013373711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM FACKLER DC

Provider Business Mailing Address
First Line	:	3301 NE 32ND AVE APT 403
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-7121
Country	:	US
Telephone Number	:	954-817-3635
Fax Number	:	954-686-8806

Provider Business Practice Location Address
First Line	:	1348 SE 17TH ST
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-1708
Country	:	US
Telephone Number	:	954-817-3635
Fax Number	:	954-686-8806

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

Provider Enumeration Date	:	01/11/2016
Last Update Date	:	06/14/2021

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