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General NPI Number Information
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NPI Number | 1407083777
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Entity Type | Organization
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Legal Business Name | NORTH ORLANDO SPINE CENTER, LLC
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Dates
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Enumeration Date | 06/15/2009
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 2170 W STATE ROAD 434 STE 252
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City | LONGWOOD
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State | FL
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Zip | 32779-4976
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Country | US
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Telephone | 407-331-9913
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Fax | 407-331-9918
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Provider Business Mailing Address
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Address Line | 2170 W STATE ROAD 434 STE 252
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City | LONGWOOD
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State | FL
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Zip | 32779-4976
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Country | US
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Telephone | 407-331-9913
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Fax | 407-331-9918
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. NICOLE LOUISE INGRANDO
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Credential | D.C.
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Telephone | 407-331-9913
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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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