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General NPI Number Information
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NPI Number | 1285119073
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Entity Type | Organization
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Legal Business Name | ORLANDO INTEGRATIVE MEDICINE
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Dates
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Enumeration Date | 09/27/2018
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Last Update Date | 09/27/2018
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Provider Practice Location Address
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Address Line | 1954 W SR 426 STE 1112
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City | OVIEDO
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State | FL
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Zip | 32765-8831
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Country | US
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Telephone | 407-890-9651
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Fax | 407-890-9660
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Provider Business Mailing Address
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Address Line | 1954 W SR 426 STE 1112
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City | OVIEDO
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State | FL
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Zip | 32765-8831
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Country | US
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Telephone | 407-890-9651
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Fax | 407-890-9660
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Authorized Official
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Title or Position | CEO
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Name | DR. ROBERT RAOUF ABRAHAM
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Credential | DC
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Telephone | 321-217-3986
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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 |
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License Number State |
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