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General NPI Number Information
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NPI Number | 1548041312
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Entity Type | Organization
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Legal Business Name | MEDOSH INTEGRATIVE MEDICINE, LLC
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Dates
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Enumeration Date | 10/09/2023
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 789 DOUGLAS AVE
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-2573
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Country | US
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Telephone | 504-346-9660
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Fax |
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Provider Business Mailing Address
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Address Line | 789 DOUGLAS AVE STE 137
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-2573
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Country | US
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Telephone | 321-297-1118
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELVAN SARAC-JENNINGS
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Credential | L.AC, MD-TR
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Telephone | 504-346-9660
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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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