Provider Demographics
NPI:1053651158
Name:FLORIDA CHIROPRACTIC CENTERS, PA
Entity type:Organization
Organization Name:FLORIDA CHIROPRACTIC CENTERS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:RUDY
Authorized Official - Last Name:HUNERBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-640-4500
Mailing Address - Street 1:2001 PALM BEACH LAKES BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6510
Mailing Address - Country:US
Mailing Address - Phone:561-640-4500
Mailing Address - Fax:561-640-4501
Practice Address - Street 1:2001 PALM BEACH LAKES BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6510
Practice Address - Country:US
Practice Address - Phone:561-640-4500
Practice Address - Fax:561-640-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5302111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22333OtherBCBS
FL051026200Medicaid
FL051026200Medicaid
FL22333Medicare PIN