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General NPI Number Information
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NPI Number | 1295031185
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Entity Type | Organization
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Legal Business Name | ORIENTAL MEDICAL ARTS
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Dates
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Enumeration Date | 02/10/2011
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 1802 N MILLS AVE
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City | ORLANDO
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State | FL
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Zip | 32803-1854
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Country | US
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Telephone | 407-392-1441
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Fax | 407-392-1443
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Provider Business Mailing Address
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Address Line | 1330 MAGNOLIA AVE
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City | WINTER PARK
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State | FL
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Zip | 32789
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Country | US
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Telephone | 407-325-2347
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURE PHYSICIAN
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Name | MONICA G BRADNAN
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Credential | A.P.
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Telephone | 407-325-2347
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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 | 2091
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License Number State | FL
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