Provider Demographics
NPI:1639910177
Name:SPINE SOLUTIONS OF CENTRAL FLORIDA, LLC
Entity type:Organization
Organization Name:SPINE SOLUTIONS OF CENTRAL FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCENANY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-484-2784
Mailing Address - Street 1:PO BOX 948242
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32794-8242
Mailing Address - Country:US
Mailing Address - Phone:407-484-2784
Mailing Address - Fax:
Practice Address - Street 1:11043 W COLONIAL DR STE 401
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-2976
Practice Address - Country:US
Practice Address - Phone:407-203-7635
Practice Address - Fax:407-413-8973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty