NPIMap

Organization Active NPI

Mauricio Chiropractic South L L C

  • Chiropractor
  • Orlando, FL
National Provider Identifier
1689870412
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MAURICIO CHIROPRACTIC SOUTH L L C
Practice address
12720 S Orange Blossom Trail
#20
Orlando, FL 32837
Phone
(407) 438-4888
Fax
(321) 319-0026
NPI assigned
Jun 27, 2007
Last updated
Sep 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Authorized official

Name
Dr. Richard Scott Bird
Title
Administrator
Phone
(402) 381-0878

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

12720 S Orange Blossom Trail
#20
Orlando, FL 32837

Mailing address

12278 E. Colonial Dr.
Ste 600C
Orlando, FL 32826
Phone (407) 381-0878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050727001030 FL Part B Supplier - Clinic/Group Practice 5890723217 Receives reassigned benefits from 10 practitioners
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Locations

12278 E Colonial Dr
Ste 600C
Orlando, FL 32826

12278 E Colonial Dr
Ste 700C
Orlando, FL 32826

12720 S Orange Blossom Trl
Ste 20
Orlando, FL 32837
Phone (407) 438-4888

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1689870412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12278 E. COLONIAL DR.",
            "address_2": "STE 600C",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32826",
            "telephone_number": "407-381-0878",
            "fax_number": "407-373-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12720 S ORANGE BLOSSOM TRAIL",
            "address_2": "#20",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32837",
            "telephone_number": "407-438-4888",
            "fax_number": "321-319-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAURICIO CHIROPRACTIC SOUTH L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2013-09-03",
        "status": "A",
        "authorized_official_last_name": "BIRD",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "402-381-0878",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.