Provider Demographics
NPI:1851044887
Name:INTEGRATIVE CHIROPRACTIC OF CFL
Entity Type:Organization
Organization Name:INTEGRATIVE CHIROPRACTIC OF CFL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:ISRAEL
Authorized Official - Last Name:PEREZ FREYTES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-201-3008
Mailing Address - Street 1:2613 SIMPSON RD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4675
Mailing Address - Country:US
Mailing Address - Phone:407-201-3008
Mailing Address - Fax:407-483-5002
Practice Address - Street 1:2613 SIMPSON RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4675
Practice Address - Country:US
Practice Address - Phone:407-201-3008
Practice Address - Fax:407-483-5002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty