Provider Demographics
NPI:1598168205
Name:POINCIANA CHIROPRACTIC & INJURY CENTER, PLLC
Entity Type:Organization
Organization Name:POINCIANA CHIROPRACTIC & INJURY CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMANIEGO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-305-9836
Mailing Address - Street 1:827 CYPRESS PKWY
Mailing Address - Street 2:
Mailing Address - City:POINCIANA
Mailing Address - State:FL
Mailing Address - Zip Code:34759-3408
Mailing Address - Country:US
Mailing Address - Phone:407-530-5819
Mailing Address - Fax:863-421-9002
Practice Address - Street 1:827 CYPRESS PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3408
Practice Address - Country:US
Practice Address - Phone:407-530-5819
Practice Address - Fax:863-421-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10980111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty