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NPI Code Detail

MEDICARE: DR. BRIAN DAVID BAUER D.O

MEDICARE: DR. BRIAN DAVID BAUER D.O
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
1111NR0400XRehabilitation Chiropractor7924FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17924OTHERFLLISCENSE NUMBER

General Provider Information

NPI Number : 1487877528
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN DAVID BAUER D.O
Provider Business Mailing Address
First Line : PO BOX 741235
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33474-1235
Country : US
Telephone Number : 954-941-2679
Fax Number : 954-941-6169
Provider Business Practice Location Address
First Line : 10017 CLEARY BLVD
Second Line :
City : PLANTATION
State : FL
Zip : 33324-1000
Country : US
Telephone Number : 954-916-1133
Fax Number : 954-916-0096
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/08/2007

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