Provider Demographics
NPI:1740501295
Name:J L LLORENS CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:J L LLORENS CHIROPRACTIC, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LLORENS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-422-2149
Mailing Address - Street 1:516 SOUTH DIXIE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401
Mailing Address - Country:US
Mailing Address - Phone:561-659-6636
Mailing Address - Fax:561-802-3021
Practice Address - Street 1:516 SOUTH DIXIE HIGHWAY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401
Practice Address - Country:US
Practice Address - Phone:561-659-6636
Practice Address - Fax:561-802-3021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL382189700Medicaid
FL382189700Medicaid