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General NPI Number Information
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NPI Number | 1992555304
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Entity Type | Organization
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Legal Business Name | GAIA INTEGRATIVE HEALTHCARE, PLLC
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Dates
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Enumeration Date | 03/26/2024
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 2100 LEE RD STE F
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City | WINTER PARK
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State | FL
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Zip | 32789-1862
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Country | US
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Telephone | 813-624-2491
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Fax |
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Provider Business Mailing Address
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Address Line | 13630 FOX GLOVE ST
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City | WINTER GARDEN
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State | FL
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Zip | 34787-4671
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Country | US
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Telephone | 813-624-2491
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HOSANNA SEBASTIAN
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Credential | LAC
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Telephone | 813-624-2491
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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 |
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License Number State |
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