Provider Demographics
NPI:1093084238
Name:GABALDON CHIROPRACTIC
Entity Type:Organization
Organization Name:GABALDON CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GABALDON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-802-4747
Mailing Address - Street 1:1376 LAKE BALDWIN LN
Mailing Address - Street 2:UNIT B
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-5906
Mailing Address - Country:US
Mailing Address - Phone:407-802-4747
Mailing Address - Fax:407-641-8060
Practice Address - Street 1:1376 LAKE BALDWIN LN
Practice Address - Street 2:UNIT B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-5906
Practice Address - Country:US
Practice Address - Phone:407-802-4747
Practice Address - Fax:407-641-8060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8689111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty