Provider Demographics
NPI:1033327788
Name:DANIEL ABECKJERR DC PA
Entity type:Organization
Organization Name:DANIEL ABECKJERR DC PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABECKJERR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-651-8100
Mailing Address - Street 1:177 NE 167TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-3404
Mailing Address - Country:US
Mailing Address - Phone:305-651-8100
Mailing Address - Fax:305-651-2241
Practice Address - Street 1:177 NE 167TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3404
Practice Address - Country:US
Practice Address - Phone:305-651-8100
Practice Address - Fax:305-651-2241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL004105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380081400Medicaid
FL88987Medicare ID - Type Unspecified
FL380081400Medicaid