Provider Demographics
NPI:1144095605
Name:100 CHIRO ROSADO PT ORANGE PLLC
Entity type:Organization
Organization Name:100 CHIRO ROSADO PT ORANGE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-495-4181
Mailing Address - Street 1:5517 S WILLIAMSON BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32128-8310
Mailing Address - Country:US
Mailing Address - Phone:386-444-7700
Mailing Address - Fax:386-444-7070
Practice Address - Street 1:5517 S WILLIAMSON BLVD STE 305
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32128-8310
Practice Address - Country:US
Practice Address - Phone:386-444-7700
Practice Address - Fax:386-444-7070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty