Provider Demographics
NPI:1215224134
Name:IMMEDIATE HEALTH CARE CENTERS, INC.
Entity type:Organization
Organization Name:IMMEDIATE HEALTH CARE CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEAN-MARIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:JACQUES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-822-3717
Mailing Address - Street 1:6388 SILVER STAR RD
Mailing Address - Street 2:1E
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-3235
Mailing Address - Country:US
Mailing Address - Phone:407-822-3717
Mailing Address - Fax:407-822-7250
Practice Address - Street 1:6388 SILVER STAR RD
Practice Address - Street 2:1E
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-3235
Practice Address - Country:US
Practice Address - Phone:407-822-3717
Practice Address - Fax:407-822-7250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5324111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty