Provider Demographics
NPI:1902367998
Name:ORLANDO FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ORLANDO FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-790-6400
Mailing Address - Street 1:500 N MILLS AVE STE A
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5378
Mailing Address - Country:US
Mailing Address - Phone:407-479-8359
Mailing Address - Fax:407-826-1908
Practice Address - Street 1:500 N MILLS AVE STE A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5378
Practice Address - Country:US
Practice Address - Phone:407-479-8359
Practice Address - Fax:407-826-1908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-31
Last Update Date:2019-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL743755OtherOPTUM
FL2203COtherBCBS
FL002376900Medicaid