Provider Demographics
NPI:1407819675
Name:TERRANOVA, JOHN ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANTHONY
Last Name:TERRANOVA
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 1:13882 COLUMBINE AVE
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-8150
Mailing Address - Country:US
Mailing Address - Phone:561-798-3809
Mailing Address - Fax:
Practice Address - Street 1:7362 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2529
Practice Address - Country:US
Practice Address - Phone:561-964-9331
Practice Address - Fax:561-966-5098
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005914111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU32148Medicare UPIN
FL052834000Medicare ID - Type UnspecifiedJOHN A. TERRANOVA, D.C.
FL22420Medicare ID - Type UnspecifiedJOHN A. TERRANOVA, D.C.