MEDICARE: JC CHIROPRACTIC WELLNESS CLINIC LLC

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

General Provider Information

NPI Number	:	1982537296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JC CHIROPRACTIC WELLNESS CLINIC LLC

Provider Business Mailing Address
First Line	:	3370 ROUSE RD UNIT 117
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32817-2221
Country	:	US
Telephone Number	:	787-375-6799
Fax Number	:

Provider Business Practice Location Address
First Line	:	3370 ROUSE RD UNIT 117
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32817-2221
Country	:	US
Telephone Number	:	787-375-6799
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOHAN MARTIN
Credential	:	DC
Telephone Number	:	787-375-6799

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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