MEDICARE: DEMA REHAB & INJURY CLINIC 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

General Provider Information

NPI Number	:	1760072805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEMA REHAB & INJURY CLINIC INC

Provider Business Mailing Address
First Line	:	7758 WALLACE RD STE A
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7218
Country	:	US
Telephone Number	:	407-344-4242
Fax Number	:	407-352-5883

Provider Business Practice Location Address
First Line	:	7758 WALLACE RD STE A
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7218
Country	:	US
Telephone Number	:	407-344-4242
Fax Number	:	407-352-5883

Authorized Official
Title or Position	:	OWNER
Name	:	DR. OUADI HASSINE
Credential	:	DC
Telephone Number	:	407-344-4242

Provider Enumeration Date	:	01/22/2021
Last Update Date	:	01/22/2021

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