Healthcare Provider Details

I. General information

NPI: 1831232131
Provider Name (Legal Business Name): CENTRAL FLORIDA REHAB & WELLNESS PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 08/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 E SILVER STAR RD
OCOEE FL
34761-2553
US

IV. Provider business mailing address

1607 E SILVER STAR RD
OCOEE FL
34761-2553
US

V. Phone/Fax

Practice location:
  • Phone: 407-522-5858
  • Fax: 407-522-5260
Mailing address:
  • Phone: 407-522-5858
  • Fax: 407-522-5260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCH6188
License Number StateFL

VIII. Authorized Official

Name: DR. STEVEN R HARRISON
Title or Position: PHYSICIAN OWNER
Credential: D.C.
Phone: 407-522-5858