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General NPI Number Information
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NPI Number | 1770965923
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Entity Type | Organization
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Legal Business Name | OPTIMAL HEALTH CHIROPRACTIC LLC
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 1507 PARK CENTER DR STE 1A
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City | ORLANDO
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State | FL
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Zip | 32835-5795
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Country | US
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Telephone | 321-209-4505
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Fax | 407-624-3063
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Provider Business Mailing Address
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Address Line | 1507 PARK CENTER DR STE 1A
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City | ORLANDO
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State | FL
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Zip | 32835-5795
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Country | US
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Telephone | 321-209-4505
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Fax | 407-624-3063
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ALEXANDRA ISIDOR
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Credential | D.C
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Telephone | 321-209-4505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0100X
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Taxonomy Name | Occupational Health Chiropractor
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License Number | CH10921
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License Number State | FL
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