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General NPI Number Information
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NPI Number | 1679625230
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Entity Type | Individual
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Provider Name | NICOLE MEZOFF AP
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Gender | Female
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 400 EXECUTIVE CENTER DR SUITE 202
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-2917
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Country | US
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Telephone | 561-856-3851
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Fax |
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Provider Business Mailing Address
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Address Line | 827 N J ST
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City | LAKE WORTH
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State | FL
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Zip | 33460-2514
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Country | US
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Telephone | 561-856-3851
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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 | 1856
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License Number State | FL
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