Healthcare Provider Details

I. General information

NPI: 1437929445
Provider Name (Legal Business Name): ORLANDO INJURY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2024
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 E MICHIGAN ST STE 104
ORLANDO FL
32822-2700
US

IV. Provider business mailing address

5555 E MICHIGAN ST STE 104
ORLANDO FL
32822-2700
US

V. Phone/Fax

Practice location:
  • Phone: 407-412-5567
  • Fax:
Mailing address:
  • Phone: 407-412-5567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANDREW KAMMERER
Title or Position: PART OWNER
Credential:
Phone: 317-224-7242