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General NPI Number Information
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NPI Number | 1164991923
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE BY ANDREA, LLC
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Dates
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Enumeration Date | 11/21/2018
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Last Update Date | 03/03/2020
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Provider Practice Location Address
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Address Line | 13400 SUTTON PARK DR S STE 1603
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City | JACKSONVILLE
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State | FL
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Zip | 32224-0237
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Country | US
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Telephone | 904-234-3964
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Fax |
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Provider Business Mailing Address
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Address Line | 13400 SUTTON PARK DR S STE 1603
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City | JACKSONVILLE
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State | FL
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Zip | 32224-0237
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Country | US
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Telephone | 904-234-3964
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Fax |
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | MS. ANDREA VENUS DANTI
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Credential | LAC, LMT
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Telephone | 904-234-3964
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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 |
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License Number State |
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