Dynamic Medical Rehabilitation Center of Delray Beach

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH7166 Issued in FL

Legal business name

DYNAMIC MEDICAL REHABILITATION CENTER OF DELRAY BEACH

Practice address

660 Linton Blvd
Suite# 104
Delray Beach, FL 33444-8167

Phone

(561) 272-9113

Fax

(561) 272-4115

NPI assigned

Apr 24, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael R Bastkowski, M.D.

Title

President

Phone

(954) 421-2005

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982823621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 LINTON BLVD",
            "address_2": "SUITE# 104",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334448167",
            "telephone_number": "561-272-9113",
            "fax_number": "561-272-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 LINTON BLVD",
            "address_2": "SUITE# 104",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334448167",
            "telephone_number": "561-272-9113",
            "fax_number": "561-272-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC MEDICAL REHABILITATION CENTER OF DELRAY BEACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BASTKOWSKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-421-2005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "77325",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Delray Beach, FL
• Providers in Delray Beach, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.