Provider Demographics
NPI:1518512219
Name:VILLAGES HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:VILLAGES HEALTHCARE SERVICES, LLC
Other - Org Name:CENTRAL FLORIDA REGENERATIVE MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:RESTIERI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:386-454-3941
Mailing Address - Street 1:1585 SANTA BARBARA BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-6820
Mailing Address - Country:US
Mailing Address - Phone:352-430-2121
Mailing Address - Fax:
Practice Address - Street 1:1585 SANTA BARBARA BLVD STE A
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-6820
Practice Address - Country:US
Practice Address - Phone:352-430-2121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty