MEDICARE: LAURA L MULLOY SCARLETT 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	438	FL

General Provider Information

NPI Number	:	1598970113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA L MULLOY SCARLETT A.P.

Provider Business Mailing Address
First Line	:	500 NE 5TH AVE STE 5
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-5663
Country	:	US
Telephone Number	:	561-272-7816
Fax Number	:	561-272-7566

Provider Business Practice Location Address
First Line	:	500 NE 5TH AVE STE 5
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-5663
Country	:	US
Telephone Number	:	561-272-7816
Fax Number	:	561-272-7566

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

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	07/08/2007

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