Healthcare Provider Details

I. General information

NPI: 1417595877
Provider Name (Legal Business Name): VISCONTI ACUPUNCTURE & NATURAL MEDICINE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2019
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S TUBB ST STE E2
OAKLAND FL
34760-8859
US

IV. Provider business mailing address

PO BOX 1204
OAKLAND FL
34760-1204
US

V. Phone/Fax

Practice location:
  • Phone: 407-614-1616
  • Fax: 407-614-1617
Mailing address:
  • Phone: 407-614-1616
  • Fax: 407-614-1617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL ARTHUR VISCONTI
Title or Position: PRESIDENT
Credential: LAC., ND
Phone: 407-614-1616