Florida Spine & Rehab Center, LLC

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

CH7566 Issued in FL

Legal business name

FLORIDA SPINE & REHAB CENTER, LLC

Practice address

483 N Semoran Blvd Ste 104
Winter Park, FL 32792-3800

Phone

(407) 772-2225

Fax

(407) 772-0302

NPI assigned

Jul 6, 2011

Last updated

Jan 7, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ty Anthony Trudeau, DCNPI 1235252537

Title

Physician/Owner

Phone

(407) 772-2225

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ty Anthony Trudeau, D.C.

  • Chiropractor
  • Winter Park, FL
  • NPI 1235252537
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357516800000",
    "number": "1396032793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 N. SEMORAN BLVD",
            "address_2": "SUITE 104",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924549",
            "telephone_number": "407-772-2225",
            "fax_number": "407-772-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 N SEMORAN BLVD STE 104",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923800",
            "telephone_number": "407-772-2225",
            "fax_number": "407-772-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA SPINE & REHAB CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2013-01-07",
        "status": "A",
        "authorized_official_last_name": "TRUDEAU",
        "authorized_official_first_name": "TY",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "407-772-2225",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "FL",
            "license": "CH7566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1235252537",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brittany Flositz, LMHC

• Orthopedic Chiropractor in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Orthopedic Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.