LAKE WORTH PHYSICAL MEDICINE (NPI# 1043579618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043579618 |
| Entity Type | Organization |
| Organization Name | LAKE WORTH PHYSICAL MEDICINE |
| Other Organization Name | PALM BEACH PHYSICAL MEDICINE |
| Practice Address |
1722-a South Congress Ave Palm Springs FL 33461 |
| Mailing Address |
Po Box 16836 West Palm Beach FL 33416-6836 |
| Practice Telephone | 5618685668 |
| Practice Fax Number | 5618685702 |
| Mailing Telephone | 5618685668 |
| Mailing Fax Number | 5618685702 |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2016-11-02 |
| Authorized Official Name | DR. JONATHAN GRAND (PRESIDENT) |
| Authorized Official Telephone | 5617297089 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CH9392 | FL | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Palm Beach Physical Medicine | Doing Business As Name - Organization |
| Street Address |
1722-A SOUTH CONGRESS AVE |
| City | PALM SPRINGS |
| State | FL |
| Zip Code | 33461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174167993 | Pcc Medical Holdings LLC | Health Maintenance Organization | 5055 South Congress Avenue, Suite 303, Lake Worth, FL 33461 | 2019-11-05 |
| 1841849692 | Five Star Medical Group Inc | Clinic/Center | 4300 10th Ave North, Suite 2, Lake Worth, FL 33461 | 2019-09-04 |
| 1346894375 | Patrick Pierre Jr. | Behavioral Analyst | 2430 Lake Worth Rd, Apt 2306, Lake Worth, FL 33461 | 2019-07-29 |
| 1740842699 | Amanda Shaw | Massage Therapist | 822 Lynnwood Dr, Lake Worth, FL 33461 | 2019-07-01 |
| 1043706005 | Elina Aguero Arman | Case Manager/Care Coordinator | 420 Alemeda Dr, Palm Springs, FL 33461 | 2018-07-02 |
| 1275028656 | Cagigas Dental Services Inc | Clinic/Center | 2311 10th Avenue North Suite 14, Lake Worth, FL 33461 | 2018-06-27 |
| 1972028447 | Annette Daley | Behavior Technician | 3595 2nd Ave North, Palm Springs, FL 33461 | 2017-08-07 |
| 1104349471 | Safe At Home Health Care, LLC | In Home Supportive Care | 555 Purdy Ln. #215, Palm Springs, FL 33461 | 2017-07-19 |
| 1609307271 | Yadira Perera | Assistant Behavior Analyst | 500 Davis Rd 42a, Palm Springs, FL 33461 | 2017-03-24 |
| 1982155842 | Palm Beach Addiction Center, Inc | Substance Abuse Rehabilitation Facility | 4196 Lake Worth Road, Lake Worth, FL 33461 | 2016-10-17 |
| Find all providers in zip 33461 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023633393 | Redfern Chiropractic Inc | Chiropractor | 2145 E Tahquitz Canyon Way Ste 5, Palm Springs, CA 92262-7020 | 2020-06-12 |
| 1689211476 | Marsh Henderson Munro | Chiropractor | 4050 Airport Center Dr Ste G, Palm Springs, CA 92264-1216 | 2019-11-29 |
| 1437716446 | Severson S Palm Springs Chiropractic, Inc | Chiropractor | 1276 N Palm Canyon Dr Ste 105, Palm Springs, CA 92262-4429 | 2019-05-24 |
| 1659831485 | Empire Chiropractic LLC | Chiropractor | 4915 S Congress Ave # 3b, Palm Springs, FL 33461-4734 | 2019-03-19 |
| 1518387471 | Marc Eisman | Chiropractor | 2145 Tahquitz Canyon Way, Suite 5, Palm Springs, CA 92262 | 2014-04-18 |
| 1881988905 | Lexi Sue Fisher | Chiropractor | 1281 N Gene Autry Trl, Suite L, Palm Springs, CA 92262-5418 | 2011-06-06 |
| 1730312554 | Bruce S Crawford | Chiropractor | 2825 N Los Felices Rd, #208, Palm Springs, CA 92262-1981 | 2009-08-27 |
| 1326212135 | Edelburg Chiropractic Inc. | Chiropractor | 2150 E Tahquitz Way, Suite #8, Palm Springs, CA 92262-7045 | 2008-04-14 |
| 1669683231 | Keith Yu | Chiropractor | 2326 South Congress Ave, Suite 2c, Palm Springs, FL 33406 | 2007-05-25 |
| 1477678324 | Kenneth Ray Lindsey | Chiropractor | 777 N Palm Canyon Dr, Ste 200, Palm Springs, CA 92262-5546 | 2007-03-20 |
| Find all providers in PALM SPRINGS | ||||
| City | PALM SPRINGS |
| Zip Code | 33461 |
Please comment or provide details below to improve the information on LAKE WORTH PHYSICAL MEDICINE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.