Provider Demographics
NPI:1033919196
Name:GREATER ORLANDO HEALTH AND WELLNESS CENTERS, LLC
Entity type:Organization
Organization Name:GREATER ORLANDO HEALTH AND WELLNESS CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:MARK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-250-1679
Mailing Address - Street 1:1417 LITCHEM RD
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-3068
Mailing Address - Country:US
Mailing Address - Phone:352-250-1679
Mailing Address - Fax:
Practice Address - Street 1:7200 LAKE ELLENOR DR STE 204
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-5788
Practice Address - Country:US
Practice Address - Phone:407-720-3020
Practice Address - Fax:407-720-3025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty