Provider Demographics
NPI:1538148440
Name:BRONHEIM, JEFFREY M (DC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:BRONHEIM
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 1:1035 SOUTH FEDERAL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020
Mailing Address - Country:US
Mailing Address - Phone:954-922-9355
Mailing Address - Fax:954-922-9366
Practice Address - Street 1:1035 SOUTH FEDERAL HIGHWAY
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020
Practice Address - Country:US
Practice Address - Phone:954-922-9355
Practice Address - Fax:954-922-9366
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 6757111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22985OtherBCBS
U48790Medicare UPIN
FL22985AMedicare PIN