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General NPI Number Information
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NPI Number | 1790968907
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Entity Type | Organization
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Legal Business Name | MAURICIO CHIROPRACTIC EAST INC
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 535 S CHICKASAW TRL
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City | ORLANDO
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State | FL
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Zip | 32825-7801
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Country | US
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Telephone | 407-277-1031
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Fax | 407-277-5556
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Provider Business Mailing Address
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Address Line | PO BOX 520422
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City | LONGWOOD
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State | FL
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Zip | 32752-0422
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Country | US
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Telephone | 407-260-8879
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Fax | 321-594-5809
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Authorized Official
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Title or Position | ASSISTANT OFFICE MANAGER
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Name | MRS. NETTY LEON
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Credential |
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Telephone | 407-260-8879
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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 | CH7151
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License Number State | FL
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