Provider Demographics
NPI:1346783727
Name:MAXIMUM HEALTH & WELLNESS APOPKA LLC
Entity Type:Organization
Organization Name:MAXIMUM HEALTH & WELLNESS APOPKA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE REP
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-678-3092
Mailing Address - Street 1:480 S HUNT CLUB BLVD
Mailing Address - Street 2:C/O RETRO FITNESS
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-4948
Mailing Address - Country:US
Mailing Address - Phone:407-775-6750
Mailing Address - Fax:407-775-6752
Practice Address - Street 1:480 S HUNT CLUB BLVD
Practice Address - Street 2:C/O RETRO FITNESS
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4948
Practice Address - Country:US
Practice Address - Phone:407-775-6750
Practice Address - Fax:407-775-6752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-02
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty