Provider Demographics
NPI:1972535672
Name:DUKOFSKY, MIA (DC)
Entity type:Individual
Prefix:DR
First Name:MIA
Middle Name:
Last Name:DUKOFSKY
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 1:520 NE 20TH ST APT 206
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33305-2104
Mailing Address - Country:US
Mailing Address - Phone:631-897-5246
Mailing Address - Fax:
Practice Address - Street 1:6030 HOLLYWOOD BLVD STE 250
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-7972
Practice Address - Country:US
Practice Address - Phone:954-908-6662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009134111N00000X
FLCH13886111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY139518OtherPRISM
NY5897920OtherGHI
NY113423471OtherMAGNACARE
NY7633479OtherAETNA US HEALTHCARE
NYNY09134OtherLANDMARK
NY2018267OtherUNITED HEALTHCARE
NY103013OtherHERITAGE
NY010757455OtherHORIZON HEALTHCARE
NYX5T371OtherBLUE CROSS BLUE SHIELD
NY2952860OtherOXFORD
NY470609OtherPHCS
NYC09134OtherWORKERS COMP.
NY7633479OtherAETNA US HEALTHCARE
NY5897920OtherGHI