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General NPI Number Information
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NPI Number | 1689136558
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Entity Type | Organization
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Legal Business Name | OMNIA ORTHOPEDIC AND PAIN SPECIALISTS
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Dates
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Enumeration Date | 04/01/2019
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Last Update Date | 04/05/2019
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Provider Practice Location Address
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Address Line | 1803 PARK CENTER DR
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City | ORLANDO
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State | FL
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Zip | 32835-6216
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Country | US
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Telephone | 518-365-5817
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Fax |
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Provider Business Mailing Address
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Address Line | 1803 PARK CENTER DR
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City | ORLANDO
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State | FL
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Zip | 32835-6216
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Country | US
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Telephone | 518-365-5817
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTIC PHYSICIAN
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Name | DR. MATTHEW EDWARD MCCABE
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Credential | D.C.
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Telephone | 518-365-5817
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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 |
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License Number State |
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