Provider Demographics
NPI:1942267349
Name:PAUL M ROMINE PA NORTH LAKELAND CHIROPRACTIC
Entity Type:Organization
Organization Name:PAUL M ROMINE PA NORTH LAKELAND CHIROPRACTIC
Other - Org Name:ACUTE SPINE & JOINT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROMINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:863-859-5441
Mailing Address - Street 1:5325 US HIGHWAY 98 N
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-0518
Mailing Address - Country:US
Mailing Address - Phone:863-859-5441
Mailing Address - Fax:863-815-0684
Practice Address - Street 1:5325 US HIGHWAY 98 N
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-0518
Practice Address - Country:US
Practice Address - Phone:863-859-5441
Practice Address - Fax:863-815-0684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003596111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCM2826OtherRAILROAD MEDICARE
FLCM2826OtherRAILROAD MEDICARE