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General NPI Number Information
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NPI Number | 1740869338
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Entity Type | Individual
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Provider Name | JACLYN MARIE DAMBRA DC
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Gender | Female
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Dates
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Enumeration Date | 04/02/2021
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Last Update Date | 04/02/2021
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Provider Practice Location Address
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Address Line | 877 S ORANGE BLOSSOM TRL
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City | APOPKA
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State | FL
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Zip | 32703-6522
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Country | US
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Telephone | 407-889-3223
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Fax |
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Provider Business Mailing Address
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Address Line | 9301 SUMMIT CENTRE WAY UNIT 1314
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City | ORLANDO
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State | FL
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Zip | 32810-6097
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Country | US
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Telephone | 516-547-0672
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CH1331
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License Number State | FL
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