Healthcare Provider Details

I. General information

NPI: 1992823660
Provider Name (Legal Business Name): THE TRACK - STRENGTHENING & CONDITIONING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 FRIENDSHIP DR
ORLANDO FL
32835-4407
US

IV. Provider business mailing address

475 FRIENDSHIP DR
ORLANDO FL
32835-4407
US

V. Phone/Fax

Practice location:
  • Phone: 407-578-2993
  • Fax: 407-297-7842
Mailing address:
  • Phone: 407-578-2993
  • Fax: 407-297-7842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPO5000154051
License Number StateFL

VIII. Authorized Official

Name: MRS. CASSANDRA ELOICE MORRIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 407-578-2993