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General NPI Number Information
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NPI Number | 1720620511
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Entity Type | Individual
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Provider Name | MARIA FERNANDA CARVAJAL A.P.
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Gender | Female
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Dates
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Enumeration Date | 10/13/2019
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Last Update Date | 10/13/2019
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Provider Practice Location Address
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Address Line | 917 S PARSONS AVE
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City | BRANDON
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State | FL
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Zip | 33511-6008
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Country | US
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Telephone | 813-341-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 13712 MOONSTONE CANYON DR
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City | RIVERVIEW
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State | FL
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Zip | 33579-3504
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Country | US
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Telephone | 813-399-6011
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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 | 4067
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License Number State | FL
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