Provider Demographics
NPI:1861708091
Name:HEALTH AND WELLNESS CLINIC OF S ORLANDO, INC
Entity type:Organization
Organization Name:HEALTH AND WELLNESS CLINIC OF S ORLANDO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:PFAFF
Authorized Official - Suffix:
Authorized Official - Credentials:CHIROPRACTOR
Authorized Official - Phone:407-240-0606
Mailing Address - Street 1:11364 S ORANGE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-9426
Mailing Address - Country:US
Mailing Address - Phone:407-240-0606
Mailing Address - Fax:407-240-0054
Practice Address - Street 1:11364 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-9426
Practice Address - Country:US
Practice Address - Phone:407-240-0606
Practice Address - Fax:407-240-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6162111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty