Healthcare Provider Details

I. General information

NPI: 1699089227
Provider Name (Legal Business Name): MEDICAL CARE EXPRESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2010
Last Update Date: 08/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5287 ALHAMBRA DR
ORLANDO FL
32808-7203
US

IV. Provider business mailing address

5287 ALHAMBRA DR
ORLANDO FL
32808-7203
US

V. Phone/Fax

Practice location:
  • Phone: 407-295-1441
  • Fax: 407-292-2331
Mailing address:
  • Phone: 407-295-1441
  • Fax: 407-292-2331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberME0008095
License Number StateFL

VIII. Authorized Official

Name: DR. IRVING L. COLVIN
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 407-295-1441