Healthcare Provider Details

I. General information

NPI: 1528993193
Provider Name (Legal Business Name): LUXE CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S ORLANDO AVE STE 310
WINTER PARK FL
32789-5543
US

IV. Provider business mailing address

1400 S ORLANDO AVE STE 310
WINTER PARK FL
32789-5543
US

V. Phone/Fax

Practice location:
  • Phone: 689-350-9170
  • Fax:
Mailing address:
  • Phone: 689-350-9170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: CARLOS GOMEZ
Title or Position: CHIROPRACTIC PHYSICIAN
Credential: DC
Phone: 689-350-9170