Provider Demographics
NPI:1144773094
Name:ADKORE, LLC
Entity Type:Organization
Organization Name:ADKORE, LLC
Other - Org Name:ADKORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-328-7595
Mailing Address - Street 1:1260 UPSALA RD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6668
Mailing Address - Country:US
Mailing Address - Phone:407-328-7595
Mailing Address - Fax:800-398-5605
Practice Address - Street 1:1260 UPSALA RD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-6668
Practice Address - Country:US
Practice Address - Phone:407-328-7595
Practice Address - Fax:800-398-5605
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAYALA CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-27
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty