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Organization

NIRVANA SPORTS MEDICINE AND REHABILITATION SERVICES, LLC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BECKY E MITCHELL-VAUGHN ARNP (CORPORATE SECRETARY)
(407) 647-5008
Entity
Organization

Contact information

Practice address
1890 W COUNTY ROAD 419, SUITE 1000, OVIEDO, FL 32765-4402
(407) 647-5008
(407) 374-1683
Mailing address
1890 W COUNTY ROAD 419, SUITE 1000, OVIEDO, FL 32765-4402
(407) 647-5008
(407) 374-1683

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
FL
261QR0400X
Rehabilitation Clinic/Center
Primary
FL

Other

Enumeration date
07/14/2014
Last updated
05/21/2015
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