Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CH2878 | FL |
NPI | 1639143118 |
---|---|
Provider Name | Dr. Paul M Lombardi |
First Address | Cocoa, FL 32922-7211 |
Second Address | Cocoa, FL 32922-7211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T55752 | (02) | FL |