MEDICARE: CENTRAL FLORIDA REHAB & WELLNESS PL

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	111NR0400X	Rehabilitation Chiropractor	CH6188	FL

General Provider Information

NPI Number	:	1831232131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL FLORIDA REHAB & WELLNESS PL

Provider Business Mailing Address
First Line	:	1607 E SILVER STAR RD
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-2553
Country	:	US
Telephone Number	:	407-522-5858
Fax Number	:	407-522-5260

Provider Business Practice Location Address
First Line	:	1607 E SILVER STAR RD
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-2553
Country	:	US
Telephone Number	:	407-522-5858
Fax Number	:	407-522-5260

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	DR. STEVEN R HARRISON
Credential	:	D.C.
Telephone Number	:	407-522-5858

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	08/11/2009

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