MEDICARE: STILLPOINT CLINIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AP2409	FL

General Provider Information

NPI Number	:	1205105665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STILLPOINT CLINIC LLC

Provider Business Mailing Address
First Line	:	8603 S DIXIE HWY STE 306
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-7869
Country	:	US
Telephone Number	:	305-663-8128
Fax Number	:

Provider Business Practice Location Address
First Line	:	8603 S DIXIE HWY STE 306
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-7869
Country	:	US
Telephone Number	:	305-663-8128
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JUDY KAZUKO TOMITA
Credential	:	AP
Telephone Number	:	786-210-1281

Provider Enumeration Date	:	12/14/2011
Last Update Date	:	12/14/2011

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Directions to “STILLPOINT CLINIC LLC ” Practice Location

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