Provider Demographics
NPI:1760040257
Name:TEXIDOR FELICIANO, LORREINE (DC)
Entity Type:Individual
Prefix:
First Name:LORREINE
Middle Name:
Last Name:TEXIDOR FELICIANO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 S VOLUSIA AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-7344
Mailing Address - Country:US
Mailing Address - Phone:386-220-0011
Mailing Address - Fax:386-226-0013
Practice Address - Street 1:1750 S VOLUSIA AVE STE 1
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-7344
Practice Address - Country:US
Practice Address - Phone:386-226-0011
Practice Address - Fax:386-226-0013
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12814111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor