MEDICARE: DR. BRUCE SCOTT HORNFELD 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	111NI0013X	Independent Medical Examiner Chiropractor	CH0007013	FL

General Provider Information

NPI Number	:	1104019959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE SCOTT HORNFELD D.C.

Provider Business Mailing Address
First Line	:	PO BOX 550224
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33355-0224
Country	:	US
Telephone Number	:	954-646-6942
Fax Number	:	954-476-8153

Provider Business Practice Location Address
First Line	:	1893 NE 164TH ST
Second Line	:	#100
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4168
Country	:	US
Telephone Number	:	954-646-6942
Fax Number	:	954-476-8153

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

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	08/24/2007

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