Provider Demographics
NPI:1538497144
Name:GOMBERG, LLOYD H (DC)
Entity Type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:H
Last Name:GOMBERG
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 1:22820 CHELSEA WOOD CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-1143
Mailing Address - Country:US
Mailing Address - Phone:561-613-5154
Mailing Address - Fax:561-961-4049
Practice Address - Street 1:24 SE 6TH ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-6016
Practice Address - Country:US
Practice Address - Phone:561-961-4030
Practice Address - Fax:561-961-4049
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8498111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition