Provider Demographics
NPI:1821148651
Name:C & G WELLNESS CENTER
Entity Type:Organization
Organization Name:C & G WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:OCTAVIO
Authorized Official - Last Name:IRIZARRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-671-7199
Mailing Address - Street 1:2431 ALOMA AVE
Mailing Address - Street 2:SUITE # 284
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2540
Mailing Address - Country:US
Mailing Address - Phone:407-671-7199
Mailing Address - Fax:407-671-7279
Practice Address - Street 1:2431 ALOMA AVE
Practice Address - Street 2:SUITE # 284
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2540
Practice Address - Country:US
Practice Address - Phone:407-671-7199
Practice Address - Fax:407-671-7279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty