MEDICARE: DR. STEVEN JAY SONENBLUM 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	111NS0005X	Sports Physician Chiropractor	CH0007163	FL

General Provider Information

NPI Number	:	1851594527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN JAY SONENBLUM D.C.

Provider Business Mailing Address
First Line	:	8720 NW 79TH ST
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-1620
Country	:	US
Telephone Number	:	561-633-0429
Fax Number	:	561-881-0867

Provider Business Practice Location Address
First Line	:	537 US HIGHWAY 1 STE 3
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-4903
Country	:	US
Telephone Number	:	561-881-0865
Fax Number	:	561-881-0867

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

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	07/08/2007

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