Organization Active NPI

Optimal Health Chiropractic LLC

  • Occupational Health Chiropractor
  • Orlando, FL
National Provider Identifier
1770965923
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health ChiropractorTaxonomy code 111NX0100X
License
CH10921 Issued in FL
Legal business name
OPTIMAL HEALTH CHIROPRACTIC LLC
Practice address
1507 Park Center Dr
Ste 1a
Orlando, FL 32835-5795
Phone
(321) 209-4505
Fax
(407) 624-3063
NPI assigned
Jun 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Authorized official

Name
Dr. Alexandra Isidor, D.C
Title
Chiropractor
Phone
(321) 209-4505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NX0100X CH10921 FL Primary

Addresses

Primary practice location

1507 Park Center Dr
Ste 1a
Orlando, FL 32835-5795

Mailing address

1507 Park Center Dr
Ste 1a
Orlando, FL 32835-5795
Phone (321) 209-4505

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151013001093 FL Part B Supplier - Clinic/Group Practice 9133438211 Receives reassigned benefits from 1 practitioner
Practice locations: Lutz, FL

National Provider Directory

National Provider Directory

Locations

1507 Park Center Dr
Ste 1A
Orlando, FL 32835
Phone (321) 209-4305

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444694400000",
    "number": "1770965923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 PARK CENTER DR",
            "address_2": "STE 1A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328355795",
            "telephone_number": "321-209-4505",
            "fax_number": "407-624-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 PARK CENTER DR",
            "address_2": "STE 1A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328355795",
            "telephone_number": "321-209-4505",
            "fax_number": "407-624-3063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL HEALTH CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-24",
        "last_updated": "2015-10-13",
        "status": "A",
        "authorized_official_last_name": "ISIDOR",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "321-209-4505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Occupational Health",
            "state": "FL",
            "license": "CH10921",
            "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 Oct 13, 2015; 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.