Provider Demographics
NPI:1730620337
Name:HEALTHQUEST CHIROPRACTIC AND REHABILITATION INC.
Entity type:Organization
Organization Name:HEALTHQUEST CHIROPRACTIC AND REHABILITATION INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-236-7400
Mailing Address - Street 1:7 E COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1215
Mailing Address - Country:US
Mailing Address - Phone:407-236-7400
Mailing Address - Fax:
Practice Address - Street 1:7 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-1215
Practice Address - Country:US
Practice Address - Phone:407-236-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8212111NR0400X
FLAP2198171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004097300Medicaid
FLU3692AMedicare UPIN