Organization
FLORIDA INJURY KISSIMMEE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANICIA O VICENTE (DIRECTOR OF BILLING)
(407) 367-5160
Entity
Organization
Contact information
Practice address
1040 E. OSCEOLA PARKWAY, KISSIMMEE, FL 34744
(321) 219-1000
(321) 219-1005
Mailing address
6220 S. ORANGE BLOSSOM TRAIL, SUITE 197, ORLANDO, FL 32809
(407) 367-5160
(407) 367-5175
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
HCC8292
FL
Other
Enumeration date
10/01/2010
Last updated
10/01/2010
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