MEDICARE: DR. NEIL STEVEN BONNARDEL 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	111NR0400X	Rehabilitation Chiropractor	CH6879	FL

General Provider Information

NPI Number	:	1497892004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL STEVEN BONNARDEL D.C.

Provider Business Mailing Address
First Line	:	18981 SW 32ND ST
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33029-5832
Country	:	US
Telephone Number	:	954-963-1899
Fax Number	:	954-963-5613

Provider Business Practice Location Address
First Line	:	2544 N STATE ROAD 7
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3205
Country	:	US
Telephone Number	:	954-963-1899
Fax Number	:	954-963-5613

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

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	08/31/2009

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