Provider Demographics
NPI:1558952226
Name:ELITE SPINAL CARE & REHAB CENTER LLC
Entity type:Organization
Organization Name:ELITE SPINAL CARE & REHAB CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:J
Authorized Official - Last Name:NAZARIO NAZARIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-598-8601
Mailing Address - Street 1:8915 CONROY WINDERMERE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-3127
Mailing Address - Country:US
Mailing Address - Phone:407-909-4788
Mailing Address - Fax:407-909-1788
Practice Address - Street 1:8915 CONROY WINDERMERE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3127
Practice Address - Country:US
Practice Address - Phone:407-909-4788
Practice Address - Fax:407-909-1788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty