Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH4007 | FL |
NPI | 1003907882 |
---|---|
Provider Name | Mr. Scott Mitchell Jablon |
First Address | Coral Springs, FL 33071 |
Second Address | Coral Springs, FL 33071 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T84451 | (02) |