Provider Demographics
NPI:1649060245
Name:ELEMENT WEST CENTRAL FLORIDA, LLC
Entity type:Organization
Organization Name:ELEMENT WEST CENTRAL FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN CARLOS
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRUZ GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-401-8094
Mailing Address - Street 1:1200 N CENTRAL AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4440
Mailing Address - Country:US
Mailing Address - Phone:407-401-8094
Mailing Address - Fax:
Practice Address - Street 1:103 S DIXIE DR
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-2844
Practice Address - Country:US
Practice Address - Phone:407-401-8094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELEMENT HOLDINGS GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty