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General NPI Number Information
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NPI Number | 1104059542
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Entity Type | Organization
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Legal Business Name | CENTRAL FLORIDA INSTITUTE OF CHINESE MEDICINE INC
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Dates
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Enumeration Date | 09/02/2009
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Last Update Date | 09/02/2009
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Provider Practice Location Address
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Address Line | 1298 MINNESOTA AVE SUITE A
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City | WINTER PARK
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State | FL
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Zip | 32789-7114
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Country | US
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Telephone | 407-462-7949
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Fax |
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Provider Business Mailing Address
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Address Line | 1298 MINNESOTA AVE SUITE A
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City | WINTER PARK
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State | FL
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Zip | 32789-7114
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEORGE M REYNOLDS
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Credential | A.P.
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Telephone | 407-462-7949
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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 | AP
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License Number State | FL
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