Provider Demographics
NPI:1982069001
Name:DAVIE CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:DAVIE CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBKES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-476-3100
Mailing Address - Street 1:4296 S UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3007
Mailing Address - Country:US
Mailing Address - Phone:954-476-3100
Mailing Address - Fax:954-476-0225
Practice Address - Street 1:4296 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3007
Practice Address - Country:US
Practice Address - Phone:954-476-3100
Practice Address - Fax:954-476-0225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT84516Medicare UPIN
FL70749Medicare PIN