MEDICARE: DR. KEEGAN JAMES ROPER 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	111N00000X	Chiropractor	CH8538	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	88180	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1487849469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEEGAN JAMES ROPER D.C.

Provider Business Mailing Address
First Line	:	2740 E OAKLAND PARK BLVD
Second Line	:	SUITE 101
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1677
Country	:	US
Telephone Number	:	954-491-4437
Fax Number	:	954-491-4492

Provider Business Practice Location Address
First Line	:	2740 E OAKLAND PARK BLVD
Second Line	:	SUITE 101
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1677
Country	:	US
Telephone Number	:	954-491-4437
Fax Number	:	954-491-4492

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

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	05/28/2020

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