Provider Demographics
NPI:1255418943
Name:ROTHSTEIN, TERRY PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:PAUL
Last Name:ROTHSTEIN
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 1:5817 LAKE WORTH RD
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3209
Mailing Address - Country:US
Mailing Address - Phone:561-642-9500
Mailing Address - Fax:561-642-9501
Practice Address - Street 1:5817 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3209
Practice Address - Country:US
Practice Address - Phone:561-642-9500
Practice Address - Fax:561-642-9501
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 5690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650096480OtherEIN
FL650096480OtherEIN
FLU12691Medicare UPIN