Provider Demographics
NPI:1164866067
Name:DHANJAL, MAAN (DC)
Entity type:Individual
Prefix:DR
First Name:MAAN
Middle Name:
Last Name:DHANJAL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 ROYAL PALM BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5733
Mailing Address - Country:US
Mailing Address - Phone:954-225-4007
Mailing Address - Fax:954-272-7619
Practice Address - Street 1:8100 ROYAL PALM BLVD STE 106
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5733
Practice Address - Country:US
Practice Address - Phone:954-225-4007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10875111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009028900Medicaid
FL1164866067Medicare NSC