MEDICARE: DR. CAROLYN JAFFE DOM, L.AC.

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	AP2039	FL

General Provider Information

NPI Number	:	1366774499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLYN JAFFE DOM, L.AC.

Provider Business Mailing Address
First Line	:	2004 WEDGE CT
Second Line	:
City	:	SUN CITY CTR
State	:	FL
Zip	:	33573-5160
Country	:	US
Telephone Number	:	813-633-5707
Fax Number	:	813-633-5707

Provider Business Practice Location Address
First Line	:	2004 WEDGE CT
Second Line	:
City	:	SUN CITY CTR
State	:	FL
Zip	:	33573-5160
Country	:	US
Telephone Number	:	813-633-5707
Fax Number	:	813-633-5707

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2010
Last Update Date	:	03/17/2018

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