Provider Demographics
NPI:1679392716
Name:FIELDS, VICTORIA (DC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:FIELDS
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 1:8163 GABLES COMMONS DR APT 1712
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-6469
Mailing Address - Country:US
Mailing Address - Phone:610-324-8365
Mailing Address - Fax:
Practice Address - Street 1:5367 CONROY RD STE 300
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-3560
Practice Address - Country:US
Practice Address - Phone:407-203-2061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15214111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor