Healthcare Provider Details

I. General information

NPI: 1952952756
Provider Name (Legal Business Name): FLORIDA ACUPUNCTURE AND COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2019
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 NW 43RD ST STE 1A
GAINESVILLE FL
32606-6677
US

IV. Provider business mailing address

2610 NW 43RD ST STE 1B
GAINESVILLE FL
32606-6677
US

V. Phone/Fax

Practice location:
  • Phone: 352-448-5836
  • Fax: 352-448-7789
Mailing address:
  • Phone: 352-448-5836
  • Fax: 352-448-7789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: JASON HARTZ
Title or Position: VICE PRESIDENT, CFO, OFFICE MANAGER
Credential:
Phone: 352-448-5836