Healthcare Provider Details

I. General information

NPI: 1316856214
Provider Name (Legal Business Name): COLONIAL PAIN RELIEF CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6905 W COLONIAL DR
ORLANDO FL
32818-6829
US

IV. Provider business mailing address

6905 W COLONIAL DR
ORLANDO FL
32818-6829
US

V. Phone/Fax

Practice location:
  • Phone: 407-237-0648
  • Fax: 407-237-0815
Mailing address:
  • Phone: 407-237-0648
  • Fax: 407-237-0815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHUKA ENEBELI
Title or Position: OWNER
Credential: MD
Phone: 407-237-0648