Provider Demographics
NPI:1306924345
Name:TRACHTENBERG, HOWARD LEE (DC)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:LEE
Last Name:TRACHTENBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:LEE
Other - Middle Name:
Other - Last Name:TRACHTENBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:9877 FAIRWAY COVE LN
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2823
Mailing Address - Country:US
Mailing Address - Phone:954-423-9072
Mailing Address - Fax:
Practice Address - Street 1:7420 NW 5TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1611
Practice Address - Country:US
Practice Address - Phone:954-792-3343
Practice Address - Fax:954-792-3342
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 6279111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22686AMedicare PIN
FLU 22777Medicare UPIN