Provider Demographics
NPI:1306968961
Name:BRONSON FAMILY CHIROPRACTIC, P.A.
Entity type:Organization
Organization Name:BRONSON FAMILY CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRONSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-694-8877
Mailing Address - Street 1:11000 PROSPERITY FARMS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3462
Mailing Address - Country:US
Mailing Address - Phone:561-694-8877
Mailing Address - Fax:561-694-8898
Practice Address - Street 1:11000 PROSPERITY FARMS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3462
Practice Address - Country:US
Practice Address - Phone:561-694-8877
Practice Address - Fax:561-694-8898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8569111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4686Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER