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General NPI Number Information
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NPI Number | 1235448325
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Entity Type | Organization
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Legal Business Name | FAMILY CHIROPRACTIC OF CENTRAL FLORIDA
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Dates
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Enumeration Date | 10/06/2010
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Last Update Date | 10/06/2010
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Provider Practice Location Address
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Address Line | 830 E STATE ROAD 434 SUITE 1
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City | LONGWOOD
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State | FL
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Zip | 32750-5362
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Country | US
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Telephone | 407-767-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 830 E STATE ROAD 434 SUITE 1
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City | LONGWOOD
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State | FL
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Zip | 32750-5362
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Country | US
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Telephone | 407-767-5700
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. LONNIE MEADE
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Credential | D.C.
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Telephone | 407-767-5700
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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 | CH9818
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH8237
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License Number State | FL
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