Healthcare Provider Details

I. General information

NPI: 1669079067
Provider Name (Legal Business Name): DAODE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2020
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 LAND O LAKES BLVD STE A
LUTZ FL
33549-2937
US

IV. Provider business mailing address

24842 BLAZING TRAIL WAY
LAND O LAKES FL
34639-9584
US

V. Phone/Fax

Practice location:
  • Phone: 813-803-3606
  • Fax:
Mailing address:
  • Phone: 813-955-5024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: JIMEI HE
Title or Position: FOUNDER
Credential: DOM
Phone: 813-955-5024