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General NPI Number Information
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NPI Number | 1285198861
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Entity Type | Individual
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Provider Name | JEANETTE R MIRAGLIA DACM, DOM, AP
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Gender | Female
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Dates
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Enumeration Date | 01/28/2019
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 5190 26TH ST W STE G
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City | BRADENTON
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State | FL
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Zip | 34207-2200
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Country | US
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Telephone | 941-896-9328
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Fax |
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Provider Business Mailing Address
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Address Line | 3715 14TH ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33704-1011
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Country | US
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Telephone | 941-350-9205
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Fax |
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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 | 3843
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License Number State | FL
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