| Entity Name: | BRUCE J. CHERLOW, D.C., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Jul 1988 (36 years ago) |
| Document Number: | M92134 |
| FEI/EIN Number | 650067290 |
| Address: | 6662 PARKSIDE DR., PARKLAND, FL, 33067 |
| Mail Address: | 6662 PARKSIDE DR., PARKLAND, FL, 33067 |
| ZIP code: | 33067 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215231006 | 2011-01-07 | 2011-01-07 | 6662 PARKSIDE DR, PARKLAND, FL, 330671694, US | 6662 PARKSIDE DR, PARKLAND, FL, 330671694, US | |||||||||||||||||||||||||
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| Phone | +1 954-796-0060 |
| Fax | 9543408925 |
Authorized person
| Name | DR. BRUCE J. CHERLOW |
| Role | PRESIDENT |
| Phone | 9547960060 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH5233 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 380350300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CHERLOW, BRUCE J. | Agent | 6662 PARKSIDE DRIVE, PARKLAND, FL, 33067 |
| Name | Role | Address |
|---|---|---|
| CHERLOW BRUCE J | Director | 6147 NW 40TH STREET, CORAL SPRINGS, FL, 33067 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000131443 | INFINITE HEALTH & WELLNESS GROUP | ACTIVE | 2021-09-30 | 2026-12-31 | No data | 6662 PARKSIDE DRIVE, PARKLAND, FL, 33067 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
