Provider Demographics
NPI:1588731376
Name:GROMAN, JANE ESTHER (DC)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:ESTHER
Last Name:GROMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 W PALMETTO PARK RD
Mailing Address - Street 2:SUITE 106B
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3458
Mailing Address - Country:US
Mailing Address - Phone:561-393-6793
Mailing Address - Fax:561-393-7318
Practice Address - Street 1:7301 W PALMETTO PARK RD
Practice Address - Street 2:SUITE 106B
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3458
Practice Address - Country:US
Practice Address - Phone:561-393-6793
Practice Address - Fax:561-393-7318
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6155111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22544Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER