Healthcare Provider Details

I. General information

NPI: 1578715223
Provider Name (Legal Business Name): OHANA CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2008
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16006 KEALAN CIR
MONTVERDE FL
34756-4001
US

IV. Provider business mailing address

16006 KEALAN CIR
MONTVERDE FL
34756-4001
US

V. Phone/Fax

Practice location:
  • Phone: 352-881-2446
  • Fax:
Mailing address:
  • Phone: 352-881-2446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009436
License Number StateMI

VIII. Authorized Official

Name: MICHAEL ANDERSON JR.
Title or Position: OWNER
Credential:
Phone: 352-881-2446