MEDICARE: KATARZYNA RUSNAK AP

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	171100000X	Acupuncturist	AP4292	FL

General Provider Information

NPI Number	:	1154075737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATARZYNA RUSNAK AP

Provider Business Mailing Address
First Line	:	260 LOOKOUT PL STE 205
Second Line	:
City	:	MAITLAND
State	:	FL
Zip	:	32751-4485
Country	:	US
Telephone Number	:	407-565-7996
Fax Number	:	407-338-3266

Provider Business Practice Location Address
First Line	:	4248 W TOWN CENTER BLVD STE 2
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-6107
Country	:	US
Telephone Number	:	407-440-2808
Fax Number	:

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

Provider Enumeration Date	:	02/11/2022
Last Update Date	:	03/18/2024

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