Provider Demographics
NPI:1922281583
Name:ROBERT LENTZ, M.D. , PA
Entity Type:Organization
Organization Name:ROBERT LENTZ, M.D. , PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDMOND
Authorized Official - Last Name:LENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-202-7894
Mailing Address - Street 1:PO BOX 541989
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33454-1989
Mailing Address - Country:US
Mailing Address - Phone:561-214-9200
Mailing Address - Fax:561-642-6568
Practice Address - Street 1:7408 LAKE WORTH RD
Practice Address - Street 2:SUITE100
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2531
Practice Address - Country:US
Practice Address - Phone:561-214-9200
Practice Address - Fax:561-642-6568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8379Medicare PIN