Healthcare Provider Details

I. General information

NPI: 1184166951
Provider Name (Legal Business Name): OWNORTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2016
Last Update Date: 12/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2185 E SEMORAN BLVD
APOPKA FL
32703-5712
US

IV. Provider business mailing address

2185 E SEMORAN BLVD
APOPKA FL
32703-5712
US

V. Phone/Fax

Practice location:
  • Phone: 407-584-7100
  • Fax: 407-204-9050
Mailing address:
  • Phone: 407-584-7100
  • Fax: 407-204-9050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH6499
License Number StateFL

VIII. Authorized Official

Name: JEFFREY N SHEBOVSKY
Title or Position: OWNER
Credential: DC
Phone: 407-584-7100