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General NPI Number Information
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NPI Number | 1982035770
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Entity Type | Organization
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Legal Business Name | FLORIDA CHIROPRACTIC HEALTH CENTER
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Dates
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Enumeration Date | 12/05/2013
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Last Update Date | 12/11/2013
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Provider Practice Location Address
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Address Line | 7806 LAKE UNDERHILL ROAD SUITE 104
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City | ORLANDO
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State | FL
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Zip | 32822-6751
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Country | US
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Telephone | 407-774-6800
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Fax | 407-774-6806
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Provider Business Mailing Address
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Address Line | 1900 BOOTHE CIRCLE SUITE 100
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City | ORLANDO
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State | FL
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Zip | 32822-8232
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Country | US
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Telephone | 407-730-9311
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Fax | 407-730-9310
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. EDUARDO TOBENAS
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Credential | DC
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Telephone | 407-774-6800
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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 | CH9040
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License Number State | FL
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