MEDICARE: TERRY P ROTHSTEIN, D.C.P.A.

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	CH5690	FL

General Provider Information

NPI Number	:	1255690319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TERRY P ROTHSTEIN, D.C.P.A.

Provider Business Mailing Address
First Line	:	5817 LAKE WORTH RD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-3209
Country	:	US
Telephone Number	:	561-642-9500
Fax Number	:	561-642-9501

Provider Business Practice Location Address
First Line	:	5817 LAKE WORTH RD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-3209
Country	:	US
Telephone Number	:	561-642-9500
Fax Number	:	561-642-9501

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TERRY PAUL ROTHSTEIN
Credential	:	D.C.
Telephone Number	:	561-642-9500

Provider Enumeration Date	:	05/10/2012
Last Update Date	:	05/10/2012

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