Mars Legacy LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH10386 Issued in FL

Legal business name

MARS LEGACY LLC

Practice address

230 E Marks St
Orlando, FL 32803-3819

Phone

(407) 203-1222

Fax

(407) 203-1223

NPI assigned

Oct 30, 2017

Organization subpart

No

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

Authorized official

Name

Michelle Chambers, DC

Title

Owner

Phone

(407) 203-1222

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Legacy Chirorpactic Doing business as

Locations

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519171200000",
    "number": "1619489762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E MARKS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033819",
            "telephone_number": "407-203-1222",
            "fax_number": "407-203-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E MARKS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033819",
            "telephone_number": "407-203-1222",
            "fax_number": "407-203-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARS LEGACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-30",
        "last_updated": "2018-02-21",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-203-1222",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881975803",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Chirorpactic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanya Taina Marrero
• Wildia L Marrero
• Curtice Kary Marris, DMD, MS
• Samantha Alexa Marrone, MD
• Elias Marruffo
• Alwyn Kenrick Mars, RPH
• Mishka Mars
• Nicole Marsden, ARNP
• Catherine Marse
• Darnelle Elisonore Marseille

• Chiropractor in Orlando, FL
• Providers in Orlando, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; 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.