MEDICARE: CORAL SPRINGS PHYSICIAN ASSOCIATES INC

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	CH0006211	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

General Provider Information

NPI Number	:	1720086457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORAL SPRINGS PHYSICIAN ASSOCIATES INC

Provider Business Mailing Address
First Line	:	2041 N UNIVERSITY DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-6132
Country	:	US
Telephone Number	:	954-344-4343
Fax Number	:	954-341-9411

Provider Business Practice Location Address
First Line	:	2041 N UNIVERSITY DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-6132
Country	:	US
Telephone Number	:	954-344-4343
Fax Number	:	954-341-9411

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	GARY D BOFSHEVER
Credential	:	DC
Telephone Number	:	954-344-4343

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	02/20/2008

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