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Organization
MACDERMOTT GROUP, LLC
Active
Organization
MACDERMOTT GROUP, LLC
Active
Parent organization
MACDERMOTT GROUP, LLC
Other names
Orlando Resorts Spine & Body
Organization subpart
Yes
Provider details
NPI number
Legal business name
MACDERMOTT GROUP, LLC
Authorized official
DR. JEREMY GOOD D.C. (CHIROPRACTOR)
(843) 697-6994
Entity
Organization
Contact information
Practice address
2940 MALLORY CIR STE 205, KISSIMMEE, FL 34747-1818
(407) 507-6976
Mailing address
2940 MALLORY CIR STE 205, KISSIMMEE, FL 34747-1818
(407) 507-6976
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
261Q00000X
Clinic/Center
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689902199
GROUP NPI
FL
01
—
2201B
BCBS
FL
Enumeration date
11/20/2009
Last updated
06/04/2024
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