Provider Demographics
NPI:1942519608
Name:ORLANDO MEDICAL & WELLNESS
Entity Type:Organization
Organization Name:ORLANDO MEDICAL & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
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:407-601-4941
Mailing Address - Street 1:9421 S ORANGE BLOSSOM TRL
Mailing Address - Street 2:SUITE 19A
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-8320
Mailing Address - Country:US
Mailing Address - Phone:407-601-4941
Mailing Address - Fax:407-286-5372
Practice Address - Street 1:9421 S ORANGE BLOSSOM TRL
Practice Address - Street 2:SUITE 19A
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8320
Practice Address - Country:US
Practice Address - Phone:407-601-4941
Practice Address - Fax:407-286-5372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty