Healthcare Provider Details

I. General information

NPI: 1811172125
Provider Name (Legal Business Name): MRS. WILDLIENE ABRAHAM ALADIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2008
Last Update Date: 01/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35902 HWY 27
HAINES CITY FL
33844-3737
US

IV. Provider business mailing address

702 WINDSOR ESTATES DR
DAVENPORT FL
33837-9624
US

V. Phone/Fax

Practice location:
  • Phone: 863-421-1777
  • Fax: 863-421-7070
Mailing address:
  • Phone: 863-421-6401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberPTA21129
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: