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BOLICK CLINIC, INC.
NPI 1073680088
Clinic/Center - Multi-Specialty in Maitland, FL

Active since November 29, 2006CLIA 10D0273769 · Waiver
500 E HORATIO AVE STE 5, MAITLAND, FL 32751(407) 629-5333(407) 629-5343 Get Directions Write a Review

NPPES record last updated: September 23, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bolick Clinic, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOLICK CLINIC, INC. (NPI 1073680088) is a healthcare organization registered as a multi-specialty in Maitland, Florida and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Channing C Bolick, President, as its authorized official.

NPPES Registry Identity

NPI1073680088
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameBOLICK CLINIC, INC.
Location Address500 E HORATIO AVE STE 5Maitland, FL 32751-7310
Mailing Address500 E Horatio Ave Ste 5Maitland, FL 32751-7310 · (407) 629-5333 · Fax (407) 629-5343
Phone(407) 629-5333
Fax(407) 629-5343
Organization SubpartNo
Authorized OfficialChanning C BolickPresident · (407) 629-5333
Enumeration DateNovember 29, 2006
Last NPPES UpdateSeptember 23, 2025
NPPES CertifiedSeptember 23, 2025
✔ NPI 1073680088 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedChiropractorTaxonomy 111N00000X
Also ListedAcupuncturistTaxonomy 171100000X
500 E HORATIO AVE STE 5, Maitland, FL 32751
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Other Names 1

Other NameThe Bolick Clinic

Other Identifiers 2

Medicaid3819132-00FL
Other55996FL · Blue Cross Group Number

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0273769

Bolick Clinic The · Maitland, FL
Active · expires Aug 31, 2026
CLIA Number10D0273769
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorChanning C. Bolick
Laboratory Phone(407) 629-5333
Laboratory LocationBolick Clinic The500 E Horatio Avenue, Maitland, FL 32751
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHANNING C BOLICK DC, MS
Chiropractor
500 E HORATIO AVE STE 5
MAITLAND, FL 32751
Orange County (407) 629-5333

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bolick Clinic, Inc.'s NPI number?

The NPI number for Bolick Clinic, Inc. is 1073680088. It was assigned to this organization in the NPPES registry on November 29, 2006. The provider is also known as The Bolick Clinic.

Where is Bolick Clinic, Inc. located?

Bolick Clinic, Inc. is located at 500 E Horatio Ave Ste 5, Maitland, FL 32751. The listed phone number is (407) 629-5333.

What is Bolick Clinic, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Bolick Clinic, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0273769) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bolick Clinic, Inc. was last updated on September 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.