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General NPI Number Information
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NPI Number | 1134536006
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Entity Type | Organization
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Legal Business Name | ORLANDO WELLNESS CENTER
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Dates
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Enumeration Date | 07/12/2014
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Last Update Date | 07/12/2014
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Provider Practice Location Address
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Address Line | 1650 E COLONIAL DR
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City | ORLANDO
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State | FL
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Zip | 32803-4804
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Country | US
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Telephone | 407-898-7788
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Fax | 407-370-4488
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Provider Business Mailing Address
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Address Line | 1650 E COLONIAL DR
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City | ORLANDO
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State | FL
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Zip | 32803-4804
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Country | US
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Telephone | 407-898-7788
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Fax | 407-370-4488
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. ANAS A KHALAF
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Credential | D.C.
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Telephone | 407-370-4444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH 3345
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License Number State | FL
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