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General NPI Number Information
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NPI Number | 1598134181
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Entity Type | Organization
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Legal Business Name | MIKHAIL FAMILY CHIROPRACTIC & SPORTS REHABILITATION CENTER, LLC
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Dates
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Enumeration Date | 09/24/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2601 WELLS AVE STE 121
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City | FERN PARK
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State | FL
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Zip | 32730-2000
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Country | US
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Telephone | 407-622-6295
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Fax | 407-622-2295
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Provider Business Mailing Address
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Address Line | 2601 WELLS AVE STE 121
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City | FERN PARK
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State | FL
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Zip | 32730-2000
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Country | US
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Telephone | 407-622-6295
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Fax | 407-622-2295
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Authorized Official
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Title or Position | OWNER, DIRECTOR, CHIROPRACTOR
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Name | DR. MINA MIKHAIL
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Credential | D.C
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Telephone | 407-622-6295
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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 | CH10950
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License Number State | FL
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