MEDICARE: MR. SCOTTY D HUDSON A.P.

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	AP2462	FL
2	171100000X	Acupuncturist	AP 2462	FL

General Provider Information

NPI Number	:	1497910806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTTY D HUDSON A.P.

Provider Business Mailing Address
First Line	:	2445 S VOLUSIA AVE STE C4
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-7626
Country	:	US
Telephone Number	:	407-690-7696
Fax Number	:	407-610-0287

Provider Business Practice Location Address
First Line	:	2445 S VOLUSIA AVE STE C4
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-7626
Country	:	US
Telephone Number	:	407-690-7696
Fax Number	:	407-610-0287

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

Provider Enumeration Date	:	07/24/2008
Last Update Date	:	04/15/2021

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Directions to “ MR. SCOTTY D HUDSON A.P.” Practice Location

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