MEDICARE: DR. DEBORAH FRALICKER 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	CH 4435	FL
2	363LF0000X	Family Nurse Practitioner	ARNP770742	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174569693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH FRALICKER DC

Provider Business Mailing Address
First Line	:	835 CESERY BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-5605
Country	:	US
Telephone Number	:	904-745-1444
Fax Number	:

Provider Business Practice Location Address
First Line	:	12620 BEACH BLVD
Second Line	:	SUITE 6
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-7131
Country	:	US
Telephone Number	:	904-645-0777
Fax Number	:	904-645-3483

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	04/07/2017

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