| |
9753 S Orange Blossom Trl, Suite 103, Orlando, FL 32837-7841 | |
(407) 857-8679 | |
(407) 857-8672 |
Full Name | |
---|---|
Type | Facility |
Speciality | Specialist |
Location | 9753 S Orange Blossom Trl, Orlando, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346594868 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CH10505 (Florida) | Secondary |
174400000X | Specialist | ME50492 (Florida) | Primary |
Mailing Address | Practice Location Address |
---|---|
9753 S Orange Blossom Trl, Suite 103, Orlando, FL 32837-7841 Ph: (407) 857-8679 | 9753 S Orange Blossom Trl, Suite 103, Orlando, FL 32837-7841 Ph: (407) 857-8679 |