=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831262146
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | THOMAS PATULLO AP OTR
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/16/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3872 SHERIDAN STREET FLORIDA BALANCE CENTERS INC DBA ACUPUNCTURE & INTEGRAI
-----------------------------------------------------
City | HOLLYWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-987-7077
-----------------------------------------------------
Fax | 954-987-7044
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3872 SHERIDAN STREET FLORIDA BALANCE CENTERS INC DBA ACUPUNCTURE & INTEGRAI
-----------------------------------------------------
City | HOLLYWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-987-7077
-----------------------------------------------------
Fax | 954-987-7044
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AP1162
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OT1273
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------