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General NPI Number Information
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NPI Number | 1932472628
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Entity Type | Organization
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Legal Business Name | AMERICAN ACADEMY OF TRADITIONAL CHINESE MEDICINE & ACUPUNCTURE
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Dates
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Enumeration Date | 02/11/2012
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Last Update Date | 02/11/2012
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Provider Practice Location Address
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Address Line | 6906 ALOMA AVE
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City | WINTER PARK
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State | FL
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Zip | 32792-7003
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Country | US
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Telephone | 407-678-4520
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Fax | 407-678-4520
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Provider Business Mailing Address
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Address Line | 6906 ALOMA AVE
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City | WINTER PARK
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State | FL
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Zip | 32792-7003
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Country | US
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Telephone | 407-678-4520
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Fax | 407-678-4520
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Authorized Official
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Title or Position | PRESIDENT
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Name | FENG SONG
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Credential | AP. OMD
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Telephone | 407-678-4520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | AP 478
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License Number State | FL
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