MEDICARE: MS. LAURA MARCELA CHACON LIC. ACUPUNCTURIST

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	AP2395	FL

General Provider Information

NPI Number	:	1821282815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA MARCELA CHACON LIC. ACUPUNCTURIST

Provider Business Mailing Address
First Line	:	2292 CORAL WAY
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-3509
Country	:	US
Telephone Number	:	786-474-5705
Fax Number	:

Provider Business Practice Location Address
First Line	:	2292 CORAL WAY
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-3509
Country	:	US
Telephone Number	:	786-474-5705
Fax Number	:

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

Provider Enumeration Date	:	09/01/2007
Last Update Date	:	01/15/2021

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