Provider Demographics
NPI:1720678451
Name:OSPINA, CARLOS HUMBERTO (DC)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:HUMBERTO
Last Name:OSPINA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2467 E SEMORAN BLVD
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-5806
Mailing Address - Country:US
Mailing Address - Phone:407-814-0985
Mailing Address - Fax:407-814-0119
Practice Address - Street 1:2467 E SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-5806
Practice Address - Country:US
Practice Address - Phone:407-814-0985
Practice Address - Fax:407-814-0119
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13318111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor