MEDICARE: CARLOS HUMBERTO OSPINA D.C.

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	CH13318	FL

General Provider Information

NPI Number	:	1720678451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS HUMBERTO OSPINA D.C.

Provider Business Mailing Address
First Line	:	2467 E SEMORAN BLVD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-5806
Country	:	US
Telephone Number	:	407-814-0985
Fax Number	:	407-814-0119

Provider Business Practice Location Address
First Line	:	2467 E SEMORAN BLVD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-5806
Country	:	US
Telephone Number	:	407-814-0985
Fax Number	:	407-814-0119

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2021
Last Update Date	:	01/26/2021

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Directions to “ CARLOS HUMBERTO OSPINA D.C.” Practice Location

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