Orlando Resorts Spine & Body | |
2940 Mallory Cir Ste 205, Kissimmee, FL 34747-1818 | |
(407) 507-6976 | |
Not Available |
Full Name | Orlando Resorts Spine & Body |
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Type | Facility |
Speciality | Nurse Practitioner |
Location | 2940 Mallory Cir Ste 205, Kissimmee, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689902199 | NPI | - | NPPES |
1689902199 | Other | FL | GROUP NPI |
2201B | Other | FL | BCBS |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | (* (Not Available)) | Secondary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Provider Name | Bret J Macdermott |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1417035940 PECOS PAC ID: 9436125648 Enrollment ID: I20091229000025 |
Provider Name | James T Dishman |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1689680340 PECOS PAC ID: 2961439047 Enrollment ID: I20120420000403 |
Provider Name | Luis Alejandro Rosado |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1124430301 PECOS PAC ID: 9739474834 Enrollment ID: I20160829002372 |
Provider Name | Francesca Alexis St Pierre |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508409277 PECOS PAC ID: 2365827458 Enrollment ID: I20220909000887 |
Mailing Address | Practice Location Address |
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Orlando Resorts Spine & Body 2940 Mallory Cir Ste 205, Kissimmee, FL 34747-1818 Ph: (407) 507-6976 | Orlando Resorts Spine & Body 2940 Mallory Cir Ste 205, Kissimmee, FL 34747-1818 Ph: (407) 507-6976 |