MEDICARE: HILLSBORO PAIN & REHAB CENTER

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	CH8063	FL

General Provider Information

NPI Number	:	1962599902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILLSBORO PAIN & REHAB CENTER

Provider Business Mailing Address
First Line	:	2247 W HILLSBORO BLVD
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-1106
Country	:	US
Telephone Number	:	954-428-2729
Fax Number	:	954-428-2794

Provider Business Practice Location Address
First Line	:	2247 W HILLSBORO BLVD
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-1106
Country	:	US
Telephone Number	:	954-428-2729
Fax Number	:	954-428-2794

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WILLIAM FREDERICK VANDERBROOK
Credential	:	DC
Telephone Number	:	954-428-2729

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	08/22/2020

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