| Orlando City Health And Wellness | |
|
1320 S Orlando Ave Ste 3 Winter Park FL 32789-5556 | |
| (407) 504-0177 | |
| (407) 530-0779 |
| Full Name | Orlando City Health And Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 1320 S Orlando Ave Ste 3, Winter Park, Florida |
| Authorized Official Name and Position | Michael Anthony Gampolo (OWNER/MGR) |
| Authorized Official Contact | 4075040117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orlando City Health And Wellness 1320 S Orlando Ave Ste 3 Winter Park FL 32789-5556 Ph: (407) 504-0177 | Orlando City Health And Wellness 1320 S Orlando Ave Ste 3 Winter Park FL 32789-5556 Ph: (407) 504-0177 |
| NPI Number | 1962904201 |
|---|---|
| Provider Enumeration Date | 03/02/2018 |
| Last Update Date | 03/02/2018 |
| Medicare PECOS PAC ID | 3577898527 |
|---|---|
| Medicare Enrollment ID | O20190712000697 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962904201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | CH11616 (Florida) | Primary |
| Provider Name | Michael A Gampolo |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1568847572 PECOS PAC ID: 2860794450 Enrollment ID: I20160114000258 |
| Provider Name | Brooks Andrew Saunders |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1033577747 PECOS PAC ID: 4183921372 Enrollment ID: I20160404000848 |
| Provider Name | Nicole Lacek-nguyen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699219907 PECOS PAC ID: 0042567117 Enrollment ID: I20180719003560 |
| Provider Name | Jason Castellanos |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1225660749 PECOS PAC ID: 8123430451 Enrollment ID: I20201210001279 |
| Provider Name | Mariela Carolina Rivera Nieves |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1871223248 PECOS PAC ID: 4486035607 Enrollment ID: I20220720000374 |
| Provider Name | Matthew David Salas Geronimo |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1154037109 PECOS PAC ID: 9133570625 Enrollment ID: I20240109003309 |
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