Provider Demographics
NPI:1134536006
Name:ORLANDO WELLNESS CENTER
Entity type:Organization
Organization Name:ORLANDO WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:KHALAF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-370-4444
Mailing Address - Street 1:1650 E COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4804
Mailing Address - Country:US
Mailing Address - Phone:407-898-7788
Mailing Address - Fax:407-370-4488
Practice Address - Street 1:1650 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4804
Practice Address - Country:US
Practice Address - Phone:407-898-7788
Practice Address - Fax:407-370-4488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-12
Last Update Date:2014-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 3345111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty