MEDICARE: FERRERA INJURY & WELLNESS CENTER

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
1	111N00000X	Chiropractor	CH7128	FL

General Provider Information

NPI Number	:	1427386606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FERRERA INJURY & WELLNESS CENTER

Provider Business Mailing Address
First Line	:	11547 LAKE UNDERHILL RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-5001
Country	:	US
Telephone Number	:	407-826-1951
Fax Number	:	407-826-1954

Provider Business Practice Location Address
First Line	:	11547 LAKE UNDERHILL RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-5001
Country	:	US
Telephone Number	:	407-826-1951
Fax Number	:	407-826-1954

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. DAVID R EDMONDSON
Credential	:	D.C.
Telephone Number	:	407-826-1951

Provider Enumeration Date	:	11/25/2009
Last Update Date	:	11/25/2009

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