Organization
FLORIDA PAIN & WELLNESS CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL WILDS DC (OWNER)
(407) 275-9335
Entity
Organization
Contact information
Practice address
5243 E COLONIAL DR, ORLANDO, FL 32807-1895
(407) 275-9335
(407) 275-9991
Mailing address
PO BOX 140038, ORLANDO, FL 32814-0038
(407) 275-9335
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Enumeration date
08/03/2011
Last updated
06/08/2015
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