MEDICARE: PRIMO SPINE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1669359782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMO SPINE LLC

Provider Business Mailing Address
First Line	:	14414 BLACK LAKE PRESERVE ST
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-5242
Country	:	US
Telephone Number	:	321-274-3951
Fax Number	:	407-217-6971

Provider Business Practice Location Address
First Line	:	1805 MAGUIRE RD STE 135
Second Line	:
City	:	WINDERMERE
State	:	FL
Zip	:	34786-7924
Country	:	US
Telephone Number	:	407-217-6969
Fax Number	:	407-217-6971

Authorized Official
Title or Position	:	OWNER/CHIROPRACTIC PHYSICIAN
Name	:	DR. JAE SUK OH
Credential	:	DC
Telephone Number	:	407-217-6969

Provider Enumeration Date	:	08/20/2025
Last Update Date	:	08/20/2025

Similar Medicare Providers

1194673616 — OGDEN ORTHODONTICS OF LAKE COUNTY LLC
Practice Location Address:

1805 MAGUIRE RD STE 101
WINDERMERE, FL
34786-7924

Practice Phone: 407-909-3003
Practice Fax: 407-909-3004

1548777246 — DR. JAE OH D.C.
Practice Location Address:

1805 MAGUIRE RD STE 135
WINDERMERE, FL
34786-7924

Practice Phone: 407-217-6969
Practice Fax: 407-217-6971

1609096502 — MAY CHEN DMD
Practice Location Address:

1805 MAGUIRE RD STE 159
WINDERMERE, FL
34786-7924

Practice Phone: 407-876-6708
Practice Fax:

1275819450 — WINDERMERE CHIROPRACTIC, PLLC
Practice Location Address:

1805 MAGUIRE RD , SUITE 135
WINDERMERE, FL
34786-7924

Practice Phone: 407-217-6969
Practice Fax:

1649128448 — ELIZABETH CHRISTINE URONU
Practice Location Address:

9300 CONROY WINDERMERE RD UNIT 1189
WINDERMERE, FL
34786-5048

Practice Phone: 814-599-7434
Practice Fax:

1023965761 — LEONARDO PEREIRA ALEXANDRE
Practice Location Address:

7432 RIPPLEPOINTE WAY
WINDERMERE, FL
34786-5717

Practice Phone: 321-389-0238
Practice Fax:

Directions to “PRIMO SPINE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.