Healthcare Provider Details

I. General information

NPI: 1972798155
Provider Name (Legal Business Name): MISTI GAYLE OXFORD-PICKERAL M.AC., AP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2007
Last Update Date: 09/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 SE 2ND AVE
GAINESVILLE FL
32601-6811
US

IV. Provider business mailing address

3415 NW 5TH ST
GAINESVILLE FL
32609-2259
US

V. Phone/Fax

Practice location:
  • Phone: 352-213-6841
  • Fax:
Mailing address:
  • Phone: 352-213-6841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP 2418
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: