Provider Demographics
NPI:1942597075
Name:SPINAL HEALTH CARE OF ORLANDO, P.A.
Entity Type:Organization
Organization Name:SPINAL HEALTH CARE OF ORLANDO, P.A.
Other - Org Name:SPINAL HEALTH CARE OF ORLANDO, P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:BLONDINE
Authorized Official - Last Name:CAYO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-870-8811
Mailing Address - Street 1:PO BOX 421846
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34742-1846
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1206 N JOHN YOUNG PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4206
Practice Address - Country:US
Practice Address - Phone:407-870-8811
Practice Address - Fax:407-870-0648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8059111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL382153600Medicaid
FLBP639ZMedicare Oscar/Certification
FL382153600Medicaid
FL86-454-9007Medicare PIN