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General NPI Number Information
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NPI Number | 1215224134
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Entity Type | Organization
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Legal Business Name | IMMEDIATE HEALTH CARE CENTERS, INC.
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 06/29/2011
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Provider Practice Location Address
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Address Line | 6388 SILVER STAR RD 1E
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City | ORLANDO
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State | FL
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Zip | 32818-3235
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Country | US
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Telephone | 407-822-3717
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Fax | 407-822-7250
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Provider Business Mailing Address
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Address Line | 6388 SILVER STAR RD 1E
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City | ORLANDO
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State | FL
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Zip | 32818-3235
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Country | US
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Telephone | 407-822-3717
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Fax | 407-822-7250
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Authorized Official
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Title or Position | OWNER
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Name | MR. JEAN-MARIE R JACQUES
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Credential |
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Telephone | 407-822-3717
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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 | HCC5324
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License Number State | FL
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