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General NPI Number Information
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NPI Number | 1104053115
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Entity Type | Organization
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Legal Business Name | ORANGE MEDICAL SPA, LLC
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Dates
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Enumeration Date | 06/17/2009
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Last Update Date | 06/17/2009
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Provider Practice Location Address
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Address Line | 5740 OLD CHENEY HWY
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City | ORLANDO
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State | FL
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Zip | 32807-3525
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Country | US
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Telephone | 407-823-9452
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Fax | 407-823-9455
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Provider Business Mailing Address
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Address Line | PO BOX 678504
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City | ORLANDO
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State | FL
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Zip | 32867-8504
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Country | US
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Telephone | 407-823-9452
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Fax | 407-823-9455
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Authorized Official
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Title or Position | MANAGER
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Name | LUZ ARGUINZONI
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Credential |
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Telephone | 407-823-9452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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