Provider Demographics
NPI:1801514047
Name:METROWEST SPINE & REHABILITATION CENTER PLLC
Entity type:Organization
Organization Name:METROWEST SPINE & REHABILITATION CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YANINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GENAO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-802-4476
Mailing Address - Street 1:222 S KIRKMAN RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811
Mailing Address - Country:US
Mailing Address - Phone:407-802-4476
Mailing Address - Fax:407-942-3316
Practice Address - Street 1:222 S KIRKMAN RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811
Practice Address - Country:US
Practice Address - Phone:407-802-4476
Practice Address - Fax:407-942-3316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty