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General NPI Number Information
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NPI Number | 1023075751
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Entity Type | Organization
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Legal Business Name | MARY CETAN DOM PA
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2344 BEE RIDGE RD SUITE 112-D
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City | SARASOTA
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State | FL
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Zip | 34239-6275
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Country | US
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Telephone | 941-926-7899
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Fax | 941-926-7899
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Provider Business Mailing Address
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Address Line | 2344 BEE RIDGE RD SUITE 112-D
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City | SARASOTA
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State | FL
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Zip | 34239-6275
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Country | US
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Telephone | 941-926-7899
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Fax | 941-926-7899
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Authorized Official
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Title or Position | DOCTOR ORIENTAL MEDICINE
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Name | DR. MARY CETAN
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Credential | DOM
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Telephone | 941-926-7899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP1303
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License Number State | FL
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