Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CH0003988 | FL |
NPI | 1003877556 |
---|---|
Provider Name | Ronald B Feldman |
First Address | Tamarac, FL 33321-1541 |
Second Address | Tamarac, FL 33321-1541 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 28/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
380109800 | (05) | FL |
T56015 | (02) | FL |