MEDICARE: MRS. WILDLIENE ABRAHAM ALADIN

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	111NR0400X	Rehabilitation Chiropractor	PTA21129	FL

General Provider Information

NPI Number	:	1811172125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. WILDLIENE ABRAHAM ALADIN

Provider Business Mailing Address
First Line	:	702 WINDSOR ESTATES DR
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33837-9624
Country	:	US
Telephone Number	:	863-421-6401
Fax Number	:

Provider Business Practice Location Address
First Line	:	35902 HWY 27
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-3737
Country	:	US
Telephone Number	:	863-421-1777
Fax Number	:	863-421-7070

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2008
Last Update Date	:	01/04/2008

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