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General NPI Number Information
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NPI Number | 1265021554
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Entity Type | Individual
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Provider Name | DUSTIN L. VAUGHAN MSOM, DIPL. O.M., AP
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Gender | Male
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Dates
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Enumeration Date | 01/12/2021
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Last Update Date | 02/23/2021
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Provider Practice Location Address
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Address Line | 835 7TH ST UNIT 1
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City | CLERMONT
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State | FL
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Zip | 34711-2190
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Country | US
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Telephone | 352-901-4513
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Fax |
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Provider Business Mailing Address
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Address Line | 877 W MINNEOLA AVE UNIT 121262
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City | CLERMONT
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State | FL
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Zip | 34712-7052
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Country | US
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Telephone | 352-901-4513
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Fax | 352-404-7640
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | AP4214
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License Number State | FL
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