MEDICARE: THERESA BARCUS L.AP, DOM, MOA, CAIT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175L00000X	Homeopath	AP4675	FL
2	174H00000X	Health Educator	AP4675	FL
3	171100000X	Acupuncturist	AP4675	FL

General Provider Information

NPI Number	:	1093251720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA BARCUS L.AP, DOM, MOA, CAIT

Provider Business Mailing Address
First Line	:	3912 LA FLOR DR
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-5333
Country	:	US
Telephone Number	:	941-879-7388
Fax Number	:	321-616-7200

Provider Business Practice Location Address
First Line	:	3190 SUNTREE BLVD STE 101
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-5741
Country	:	US
Telephone Number	:	941-879-7388
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2017
Last Update Date	:	03/16/2026

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