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General NPI Number Information
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NPI Number | 1639629447
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Entity Type | Organization
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Legal Business Name | FLORIDA INJURY AND WELLNESS CENTER
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Dates
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Enumeration Date | 10/05/2016
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 27454 CASHFORD CIR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-8199
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Country | US
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Telephone | 813-973-4747
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Fax | 813-973-3799
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Provider Business Mailing Address
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Address Line | 27454 CASHFORD CIR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-8199
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Country | US
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Telephone | 813-973-4747
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Fax | 813-973-3799
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Authorized Official
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Title or Position | PRESIDENT
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Name | JONATHAN HANCOCK
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Credential | DC
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Telephone | 813-973-4747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | CH10081
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License Number State | FL
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