Healthcare Provider Details

I. General information

NPI: 1003164674
Provider Name (Legal Business Name): ODED SCHNEIDERMAN L.AC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2142 NE 123RD ST
NORTH MIAMI FL
33181-2902
US

IV. Provider business mailing address

1801 NE 123RD ST STE 314
NORTH MIAMI FL
33181-2883
US

V. Phone/Fax

Practice location:
  • Phone: 305-967-8976
  • Fax:
Mailing address:
  • Phone: 646-784-1060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP 3121
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: