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CHIROLAB 360 SPORT & SPINE PLLC
NPI 1700753613
Chiropractor in Mount Dora, FL

Active since October 23, 2025CLIA 10D2343308 · Waiver
3800 LAKE CENTER DR STE 4, MOUNT DORA, FL 32757(407) 756-9327 Get Directions Write a Review

NPPES record last updated: January 26, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 26, 2026, Jan 5, 2026, Dec 4, 2025 (3 updates tracked since 2025).

About Chirolab 360 Sport & Spine Pllc NPPES

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

CHIROLAB 360 SPORT & SPINE PLLC (NPI 1700753613) is a healthcare organization registered as a chiropractor in Mount Dora, Florida and active in the NPI registry since October 2025. The organization holds a CLIA Waiver certificate valid through May 4, 2028 and lists Jasmine Nicole Ambrosio, Dc, as its authorized official.

NPPES Registry Identity

NPI1700753613
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameCHIROLAB 360 SPORT & SPINE PLLC
Location Address3800 LAKE CENTER DR STE 4Mount Dora, FL 32757-2208
Mailing Address522 S Hunt Club Blvd # 201Apopka, FL 32703-4960 · (407) 756-9327
Phone(407) 756-9327
Organization SubpartNo
Authorized OfficialJasmine Nicole AmbrosioDc · (407) 756-9327
Enumeration DateOctober 23, 2025
Last NPPES UpdateJanuary 26, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 26, 2026
✔ NPI 1700753613 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
3800 LAKE CENTER DR STE 4, Mount Dora, FL 32757
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chirolab 360 Sport & Spine Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Chirolab 360 Sport & Spine PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jasmine Ambrosio, DC
Chiropractic
NPI 1881584712
3800 LAKE CENTER DR STE 4
Mount Dora, FL 32757
(407) 756-9327
✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 10D2343308

Chirolab 360 Sport + Spine PLLC · Mount Dora, FL
Active · expires May 4, 2028
CLIA Number10D2343308
Laboratory TypePhysician Office
Certificate Effective DateMay 5, 2026
Certificate Expiration DateMay 4, 2028
Laboratory DirectorJasmine N. Ambrosio
Laboratory Phone(352) 844-8629
Laboratory LocationChirolab 360 Sport + Spine PLLC3800 Lake Center Drive Suite B4, Mount Dora, FL 32757
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 Chirolab 360 Sport & Spine PLLC's NPI number?

The NPI number for Chirolab 360 Sport & Spine PLLC is 1700753613. It was assigned to this organization in the NPPES registry on October 23, 2025.

Where is Chirolab 360 Sport & Spine PLLC located?

Chirolab 360 Sport & Spine PLLC is located at 3800 Lake Center Dr Ste 4, Mount Dora, FL 32757. The listed phone number is (407) 756-9327.

What is Chirolab 360 Sport & Spine PLLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Chirolab 360 Sport & Spine PLLC enrolled in Medicare?

Yes. Chirolab 360 Sport & Spine PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Chirolab 360 Sport & Spine PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Chirolab 360 Sport & Spine PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Chirolab 360 Sport & Spine PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2343308) is associated with this NPI, valid through May 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Chirolab 360 Sport & Spine PLLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Chirolab 360 Sport & Spine PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Chirolab 360 Sport & Spine PLLC was last updated on January 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.