Healthcare Provider Details

I. General information

NPI: 1497874788
Provider Name (Legal Business Name): CENTRAL FLORIDA REHAB CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 SILVER STAR RD SUITE 210
ORLANDO FL
32818-3297
US

IV. Provider business mailing address

6900 SILVER STAR RD SUITE 210
ORLANDO FL
32818-3297
US

V. Phone/Fax

Practice location:
  • Phone: 407-297-0194
  • Fax: 407-297-0737
Mailing address:
  • Phone: 407-297-0194
  • Fax: 407-297-0737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberHCC3990
License Number StateFL

VIII. Authorized Official

Name: MISS YANICK DUMESLE
Title or Position: PRESIDENT
Credential:
Phone: 407-297-0194