=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043675721
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALING WAYS P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2015
-----------------------------------------------------
Last Update Date | 12/22/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 665 HAROLD AVE SUITE A
-----------------------------------------------------
City | WINTER PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32789-4677
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-970-7148
-----------------------------------------------------
Fax | 407-536-4331
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3120 ORLEANS WAY S
-----------------------------------------------------
City | APOPKA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32703-5921
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-970-7148
-----------------------------------------------------
Fax | 407-536-4331
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MS. MARNA G RASMUSSEN
-----------------------------------------------------
Credential | A.P.
-----------------------------------------------------
Telephone | 407-970-7148
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AP 1624
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------