Provider Demographics
NPI:1467893362
Name:MEYERHEREDIA MEDICAL AND CHIROPRACTIC
Entity Type:Organization
Organization Name:MEYERHEREDIA MEDICAL AND CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:REINALDO
Authorized Official - Last Name:HEREDIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-240-9500
Mailing Address - Street 1:34 S PARK AVE
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-4253
Mailing Address - Country:US
Mailing Address - Phone:407-240-9500
Mailing Address - Fax:407-814-9914
Practice Address - Street 1:34 S PARK AVE
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4253
Practice Address - Country:US
Practice Address - Phone:407-240-9500
Practice Address - Fax:407-814-9914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7044261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service