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NPI Code Detail

MEDICARE: DR. YLLSON WILSON TALO D.C.

MEDICARE: DR. YLLSON WILSON TALO D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCH8664FL

General Provider Information

NPI Number : 1386600930
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YLLSON WILSON TALO D.C.
Provider Business Mailing Address
First Line : 10014 SILMARIEN ST
Second Line :
City : ORLANDO
State : FL
Zip : 32825-9106
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 110 N KIRKMAN RD
Second Line :
City : ORLANDO
State : FL
Zip : 32811-1404
Country : US
Telephone Number : 407-291-1000
Fax Number : 407-291-2538
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2006
Last Update Date : 07/08/2007

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