Healthcare Provider Details

I. General information

NPI: 1851214589
Provider Name (Legal Business Name): LISA V VANOSTRAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 NE 73RD ST
MIAMI FL
33138-5112
US

IV. Provider business mailing address

650 NE 73RD ST
MIAMI FL
33138-5112
US

V. Phone/Fax

Practice location:
  • Phone: 786-512-7096
  • Fax:
Mailing address:
  • Phone: 786-512-7096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP3438
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: