Healthcare Provider Details

I. General information

NPI: 1720178858
Provider Name (Legal Business Name): ANTHONY V FILARDO DC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 N WYMORE RD
WINTER PARK FL
32789
US

IV. Provider business mailing address

606 N WYMORE RD
WINTER PARK FL
32789
US

V. Phone/Fax

Practice location:
  • Phone: 407-622-2251
  • Fax: 407-622-2253
Mailing address:
  • Phone: 407-622-2251
  • Fax: 407-622-2253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH7546
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberCH7546
License Number StateFL

VIII. Authorized Official

Name: ANTHONY V FILARDO
Title or Position: OWNER PRESIDENT
Credential: DC
Phone: 407-622-2251