Healthcare Provider Details

I. General information

NPI: 1124449640
Provider Name (Legal Business Name): GENE HEALY AP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2013
Last Update Date: 12/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 PINEHURST RD SUITE D
DUNEDIN FL
34698-5408
US

IV. Provider business mailing address

1130 PINEHURST RD SUITE D
DUNEDIN FL
34698-5408
US

V. Phone/Fax

Practice location:
  • Phone: 727-437-8582
  • Fax:
Mailing address:
  • Phone: 727-437-8582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP 3311
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: