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General NPI Number Information
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NPI Number | 1992321343
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Entity Type | Organization
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Legal Business Name | ELITE INTEGRATED MEDICAL CENTERS
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Dates
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Enumeration Date | 06/22/2020
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 7915 US 301 N STE 103
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City | ELLENTON
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State | FL
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Zip | 34222-3532
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Country | US
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Telephone | 941-479-4999
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Fax | 941-479-4998
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Provider Business Mailing Address
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Address Line | 723 7TH ST W
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City | PALMETTO
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State | FL
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Zip | 34221-4721
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Country | US
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Telephone | 941-479-4999
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Fax | 941-479-4998
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Authorized Official
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Title or Position | OWNER
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Name | DR. CURTIS M REYNOLDS
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Credential | D.C.
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Telephone | 941-479-4999
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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