Provider Demographics
NPI:1760728711
Name:PROCARE HEALTH & REHAB CENTERS, LLC
Entity Type:Organization
Organization Name:PROCARE HEALTH & REHAB CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:RECKSIEDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-359-0047
Mailing Address - Street 1:40 ALEXANDRIA BLVD
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-3300
Mailing Address - Country:US
Mailing Address - Phone:407-359-0047
Mailing Address - Fax:407-359-0071
Practice Address - Street 1:40 ALEXANDRIA BLVD
Practice Address - Street 2:SUITE 1020
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-3300
Practice Address - Country:US
Practice Address - Phone:407-359-0047
Practice Address - Fax:407-359-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6418111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty