Provider Demographics
NPI:1184687527
Name:MALTZMAN, RICHARD S (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:MALTZMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8799 KENDALE PL
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7009
Mailing Address - Country:US
Mailing Address - Phone:561-964-2683
Mailing Address - Fax:
Practice Address - Street 1:5804 S JOG RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-6511
Practice Address - Country:US
Practice Address - Phone:561-967-7440
Practice Address - Fax:619-679-9875
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003037111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88326Medicare ID - Type UnspecifiedRICHARD S. MALTZMAN, D.C.
FLT55785Medicare UPIN