Provider Demographics
NPI:1265025001
Name:FEDERAL INJURY TREATMENT CENTER OF FLORIDA
Entity Type:Organization
Organization Name:FEDERAL INJURY TREATMENT CENTER OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYUR
Authorized Official - Middle Name:
Authorized Official - Last Name:RESHAMWALA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-282-3654
Mailing Address - Street 1:2323 CURLEW RD STE 7E
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-9332
Mailing Address - Country:US
Mailing Address - Phone:727-600-8024
Mailing Address - Fax:
Practice Address - Street 1:2323 CURLEW RD STE 7E
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-9332
Practice Address - Country:US
Practice Address - Phone:727-600-8024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty