Healthcare Provider Details
I. General information
NPI: 1902711088
Provider Name (Legal Business Name): GAIA INTEGRATIVE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1950 LEE RD STE 210
WINTER PARK FL
32789-1863
US
IV. Provider business mailing address
1070 MONTGOMERY RD # 2392
ALTAMONTE SPRINGS FL
32714-7420
US
V. Phone/Fax
- Phone: 813-624-2491
- Fax:
- Phone: 813-624-2491
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HOSANNA
SEBASTIAN
Title or Position: OWNER
Credential: LAC
Phone: 813-624-2491