Provider Demographics
NPI:1174248207
Name:100 CHIRO ROSADO MAITLAND PLLC
Entity type:Organization
Organization Name:100 CHIRO ROSADO MAITLAND PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-510-3986
Mailing Address - Street 1:171 S ORLANDO AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5653
Mailing Address - Country:US
Mailing Address - Phone:772-201-5849
Mailing Address - Fax:
Practice Address - Street 1:171 S ORLANDO AVE STE A
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5653
Practice Address - Country:US
Practice Address - Phone:772-201-5849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty