Provider Demographics
NPI:1306977095
Name:BACK TO HEALTH OF THE PALM BEACHES
Entity type:Organization
Organization Name:BACK TO HEALTH OF THE PALM BEACHES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FLAGELLO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:561-585-3151
Mailing Address - Street 1:3520 S OCEAN BLVD
Mailing Address - Street 2:H 506
Mailing Address - City:SOUTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-5788
Mailing Address - Country:US
Mailing Address - Phone:561-585-3151
Mailing Address - Fax:
Practice Address - Street 1:660 W BOYNTON BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-3637
Practice Address - Country:US
Practice Address - Phone:561-752-5354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 0006478111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty