Provider Demographics
NPI:1447732730
Name:BRUNO C. DA ROCHA, D.C., P.A
Entity type:Organization
Organization Name:BRUNO C. DA ROCHA, D.C., P.A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUNO
Authorized Official - Middle Name:
Authorized Official - Last Name:DA ROCHA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-497-2821
Mailing Address - Street 1:2100 E HALLANDALE BEACH BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-3770
Mailing Address - Country:US
Mailing Address - Phone:305-497-2821
Mailing Address - Fax:
Practice Address - Street 1:2100 E HALLANDALE BEACH BLVD STE 205
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-3770
Practice Address - Country:US
Practice Address - Phone:305-497-2821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-03
Last Update Date:2018-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty