Provider Demographics
NPI:1487893566
Name:OROZCO, NICOLE A (DC)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:A
Last Name:OROZCO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12443 SAN JOSE BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-8646
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12443 SAN JOSE BLVD STE 303
Practice Address - Street 2:LIVE WELL FOR LIFE, LLC
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8649
Practice Address - Country:US
Practice Address - Phone:904-425-8070
Practice Address - Fax:904-371-4598
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9636111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor