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NPI Code Detail

MEDICARE: BIANCA POND AP, LAC

MEDICARE: BIANCA POND AP, LAC
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
1171100000XAcupuncturistAP4532FL

General Provider Information

NPI Number : 1740059625
Entity Type Code : Individual
Provider Name (Legal Business Name) : BIANCA POND AP, LAC
Provider Business Mailing Address
First Line : 200 CONGRESS PARK DR STE 202
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-4688
Country : US
Telephone Number : 561-865-5485
Fax Number :
Provider Business Practice Location Address
First Line : 200 CONGRESS PARK DR STE 202
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-4688
Country : US
Telephone Number : 561-865-5485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2023
Last Update Date : 12/29/2023

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