Provider Demographics
NPI:1700223765
Name:ROGER R. VERNO, D.C.P.A.
Entity Type:Organization
Organization Name:ROGER R. VERNO, D.C.P.A.
Other - Org Name:PAIN AND INJURY RELIEF OF LAKE WORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:VERNO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-432-6786
Mailing Address - Street 1:2407 10TH AVE N
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-3128
Mailing Address - Country:US
Mailing Address - Phone:562-432-6786
Mailing Address - Fax:
Practice Address - Street 1:2407 10TH AVE N
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-3128
Practice Address - Country:US
Practice Address - Phone:562-432-6786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5059111N00000X
FLFL1169282363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty