MEDICARE: DELRAY SPINAL CARE CENTER LLC

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	CH11609	FL

General Provider Information

NPI Number	:	1740713619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELRAY SPINAL CARE CENTER LLC

Provider Business Mailing Address
First Line	:	3185 S FEDERAL HWY
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-3277
Country	:	US
Telephone Number	:	561-571-7888
Fax Number	:

Provider Business Practice Location Address
First Line	:	3185 S FEDERAL HWY
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-3277
Country	:	US
Telephone Number	:	561-571-7888
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	DR. JUDITH ZEPHIRIN
Credential	:	DC
Telephone Number	:	561-603-2848

Provider Enumeration Date	:	04/07/2017
Last Update Date	:	04/07/2017

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