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General NPI Number Information
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NPI Number | 1891077673
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Entity Type | Organization
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Legal Business Name | OASIS MEDICAL ACUHEALING CORP
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Dates
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Enumeration Date | 09/16/2011
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Last Update Date | 09/16/2011
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Provider Practice Location Address
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Address Line | 1011 W OAK RIDGE RD SUITE B
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City | ORLANDO
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State | FL
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Zip | 32809-4765
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Country | US
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Telephone | 407-888-8411
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Fax | 407-888-8371
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Provider Business Mailing Address
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Address Line | 1011 W OAK RIDGE RD SUITE B
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City | ORLANDO
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State | FL
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Zip | 32809-4765
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Country | US
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Telephone | 407-888-8411
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Fax | 407-888-8371
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | CORA C HUTCHINSON-MOODY
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Credential | BA
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Telephone | 954-695-9620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME60805
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP2122
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License Number State | FL
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