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General NPI Number Information
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NPI Number | 1487920237
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA TREATMENT CENTERS, INC.
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 07/31/2013
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Provider Practice Location Address
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Address Line | 601 N BUMBY AVE STE C
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City | ORLANDO
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State | FL
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Zip | 32803-4904
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Country | US
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Telephone | 407-704-8878
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Fax | 407-704-8879
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Provider Business Mailing Address
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Address Line | 601-C NORTH BUMBY AVE
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City | ORLANDO
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State | FL
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Zip | 32803-4904
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Country | US
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Telephone | 407-704-8878
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Fax | 407-704-8879
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Authorized Official
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Title or Position | OWNER
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Name | NANCY L KOPITNIK
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Credential | D.O.
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Telephone | 407-704-8878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | OS6229
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License Number State | FL
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