Healthcare Provider Details

I. General information

NPI: 1679494108
Provider Name (Legal Business Name): SCIMOTECH ORLANDO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 W GORE ST STE 202
ORLANDO FL
32806-1014
US

IV. Provider business mailing address

4707 CRAWFORD RD
FORT WAYNE IN
46845-9595
US

V. Phone/Fax

Practice location:
  • Phone: 407-234-1618
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: RYAN SCHLOTTERBACK
Title or Position: PRESIDENT
Credential:
Phone: 574-265-5308