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General NPI Number Information
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NPI Number | 1770830747
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Entity Type | Organization
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Legal Business Name | ORLANDO ACUPUNCTURE AND WELLNESS, LLC
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 300 WILSHIRE BLVD SUITE 237
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City | CASSELBERRY
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State | FL
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Zip | 32707-5378
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Country | US
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Telephone | 954-993-0994
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Fax |
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Provider Business Mailing Address
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Address Line | 1922 BONANZA CT
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City | WINTER PARK
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State | FL
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Zip | 32792-2026
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Country | US
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Telephone | 954-993-0994
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | MR. NEAL C BRADY
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Credential | L.AC.
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Telephone | 954-993-0994
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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 | AP2300
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License Number State | FL
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