MEDICARE: DR NICOLE A ROTHMAN, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH0007423	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619103066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR NICOLE A ROTHMAN, PA

Provider Business Mailing Address
First Line	:	1871 W WOOLBRIGHT RD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-6321
Country	:	US
Telephone Number	:	561-740-2340
Fax Number	:

Provider Business Practice Location Address
First Line	:	1871 W WOOLBRIGHT RD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-6321
Country	:	US
Telephone Number	:	561-740-2340
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NICOLE ROTHMAN
Credential	:	DC
Telephone Number	:	561-740-2340

Provider Enumeration Date	:	05/29/2009
Last Update Date	:	06/07/2009

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