Organization Active NPI

Mauricio Chiropractic Clinics PA

  • Chiropractor
  • Winter Park, FL
National Provider Identifier
1982884698
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6763 Issued in FL
Legal business name
MAURICIO CHIROPRACTIC CLINICS PA
Practice address
1810 Semoran Blvd
Ste 104
Winter Park, FL 32792
Phone
(407) 672-1616
Fax
(407) 672-0613
NPI assigned
Nov 9, 2007
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
Richard Scott Bird
Title
Administrator
Phone
(407) 381-0878

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH6763 FL Primary

Addresses

Primary practice location

1810 Semoran Blvd
Ste 104
Winter Park, FL 32792

Mailing address

12278 E Colonial Drive
Ste. 600F
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
O20050723000086 FL Part B Supplier - Clinic/Group Practice 2860429669 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Orlando, FL; Winter Park, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

12278 E Colonial Dr
Ste 600F
Orlando, FL 32826

1810 State Road 436
Ste 104
Winter Park, FL 32792
Phone (407) 672-1616

Practitioners & affiliated clinicians

Practitioners 11

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": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1982884698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12278 E COLONIAL DRIVE",
            "address_2": "STE. 600F",
            "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": "1810 SEMORAN BLVD",
            "address_2": "STE 104",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32792",
            "telephone_number": "407-672-1616",
            "fax_number": "407-672-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAURICIO CHIROPRACTIC CLINICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "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": "407-381-0878"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, 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.