Healthcare Provider Details

I. General information

NPI: 1669504916
Provider Name (Legal Business Name): JANINE MARIE MARGEWICZ L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 WINTER GARDEN VINELAND RD SUITE 124
WINTER GARDEN FL
34787
US

IV. Provider business mailing address

142 N HIGHLAND AVE
WINTER GARDEN FL
34787-2738
US

V. Phone/Fax

Practice location:
  • Phone: 407-617-7378
  • Fax:
Mailing address:
  • Phone: 407-617-7378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number2269
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: