MEDICARE: COLE CHANDLER 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	CH15515	FL

General Provider Information

NPI Number	:	1184514457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLE CHANDLER DC

Provider Business Mailing Address
First Line	:	210 NW 9TH AVE # 1
Second Line	:
City	:	DANIA
State	:	FL
Zip	:	33004-2737
Country	:	US
Telephone Number	:	937-380-5816
Fax Number	:

Provider Business Practice Location Address
First Line	:	1925 CORDOVA RD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-2157
Country	:	US
Telephone Number	:	305-607-8654
Fax Number	:

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

Provider Enumeration Date	:	07/08/2025
Last Update Date	:	07/08/2025

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Directions to “ COLE CHANDLER DC” Practice Location

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