Provider Demographics
NPI:1144274796
Name:RATTEY, THERESA E (MD)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:E
Last Name:RATTEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-4746
Mailing Address - Country:US
Mailing Address - Phone:561-967-6500
Mailing Address - Fax:561-433-4175
Practice Address - Street 1:4801 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-4746
Practice Address - Country:US
Practice Address - Phone:561-967-6500
Practice Address - Fax:561-963-5600
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69095207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000171200Medicaid
FL000171200Medicaid
28321YMedicare PIN