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General NPI Number Information
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NPI Number | 1730503343
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC & FUNCTIONAL MEDICINE PHYSICIANS OF CENTRAL FLORIDA LLC
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Dates
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Enumeration Date | 02/18/2014
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Last Update Date | 02/18/2014
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Provider Practice Location Address
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Address Line | 220 E CENTRAL PKWY SUITE 1030
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-3417
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Country | US
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Telephone | 321-444-6750
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Fax | 321-444-6755
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Provider Business Mailing Address
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Address Line | 220 E CENTRAL PKWY SUITE 1030
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-3417
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Country | US
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Telephone | 321-444-6750
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Fax | 321-444-6755
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. DANA O'KEEFE
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Credential | D.C.
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Telephone | 321-444-6750
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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 | CH11104
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License Number State | FL
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