Provider Demographics
NPI:1972710986
Name:LAKE WORTH MEDICAL & REHAB, LLC
Entity type:Organization
Organization Name:LAKE WORTH MEDICAL & REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTAGLIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-969-3232
Mailing Address - Street 1:2910 JOG RD
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2002
Mailing Address - Country:US
Mailing Address - Phone:561-969-3232
Mailing Address - Fax:561-969-3325
Practice Address - Street 1:2910 JOG RD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33467-2002
Practice Address - Country:US
Practice Address - Phone:561-969-3232
Practice Address - Fax:561-969-3325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3686111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty