=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841574944
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WINTER SPRINGS CHIROPRACTIC CENTER PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2011
-----------------------------------------------------
Last Update Date | 10/06/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1340 TUSKAWILLA RD SUITE 112
-----------------------------------------------------
City | WINTER SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32708-5030
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-699-4420
-----------------------------------------------------
Fax | 407-695-7887
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1340 TUSKAWILLA RD SUITE 112
-----------------------------------------------------
City | WINTER SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32708-5030
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-699-4420
-----------------------------------------------------
Fax | 407-695-7887
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. JAMES LOUIS SOLANA JR.
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 407-699-4420
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH 9407
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------