Provider Demographics
NPI:1578320198
Name:ELEMENT HOLDINGS GROUP, LLC
Entity Type:Organization
Organization Name:ELEMENT HOLDINGS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN CARLOS
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:CRUZ GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:202-627-0015
Mailing Address - Street 1:6565 CYRILS DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-8957
Mailing Address - Country:US
Mailing Address - Phone:407-401-8094
Mailing Address - Fax:
Practice Address - Street 1:9460 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8321
Practice Address - Country:US
Practice Address - Phone:407-401-8094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty