=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447677299
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEYER MEDICAL AND CHIROPRACTIC 1
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/18/2014
-----------------------------------------------------
Last Update Date | 03/18/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34 S PARK AVE
-----------------------------------------------------
City | APOPKA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32703-4253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-445-4501
-----------------------------------------------------
Fax | 407-814-9914
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 34 S PARK AVE
-----------------------------------------------------
City | APOPKA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32703-4253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-445-4501
-----------------------------------------------------
Fax | 407-814-9914
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR/ OWNER
-----------------------------------------------------
Name | DR. MAX C MEYER
-----------------------------------------------------
Credential | D.C
-----------------------------------------------------
Telephone | 407-445-4500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------