Healthcare Provider Details

I. General information

NPI: 1710185632
Provider Name (Legal Business Name): FIRST CARE CHIROPRACTIC & FAMILY PRACTICE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 12/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E LANCASTER RD
ORLANDO FL
32809-6689
US

IV. Provider business mailing address

115 E LANCASTER RD
ORLANDO FL
32809-6689
US

V. Phone/Fax

Practice location:
  • Phone: 407-888-8411
  • Fax: 407-888-8371
Mailing address:
  • Phone: 407-888-8411
  • Fax: 407-888-8371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. SUZY M SALOMON
Title or Position: OFFICE ADMINSTRATOR
Credential:
Phone: 407-888-8411