Provider Demographics
NPI:1154624047
Name:SPINE INJURY SOLUTIONS, INC.
Entity type:Organization
Organization Name:SPINE INJURY SOLUTIONS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SOLANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-323-6001
Mailing Address - Street 1:3525 W. LAKE MARY BLVD.
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746
Mailing Address - Country:US
Mailing Address - Phone:407-323-6001
Mailing Address - Fax:407-323-6099
Practice Address - Street 1:3525 W. LAKE MARY BLVD.
Practice Address - Street 2:SUITE 301
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746
Practice Address - Country:US
Practice Address - Phone:407-323-6001
Practice Address - Fax:407-323-6099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9551111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty