MEDICARE: REGIONS ALL CARE CENTER INC

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	CH5124	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CH5124	OTHER	FL	CH LICENSE

General Provider Information

NPI Number	:	1720424658
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONS ALL CARE CENTER INC

Provider Business Mailing Address
First Line	:	5385 CONROY RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-3719
Country	:	US
Telephone Number	:	407-872-2215
Fax Number	:	407-872-2221

Provider Business Practice Location Address
First Line	:	5385 CONROY RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-3719
Country	:	US
Telephone Number	:	407-872-2215
Fax Number	:	407-872-2221

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. PHIL HELLER
Credential	:	CH
Telephone Number	:	407-872-2215

Provider Enumeration Date	:	05/19/2013
Last Update Date	:	05/19/2013

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