MEDICARE: DR. TODD ERIK GEGERSON A.P.

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	2226	FL

General Provider Information

NPI Number	:	1255442943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD ERIK GEGERSON A.P.

Provider Business Mailing Address
First Line	:	1642 E CONCORD ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-4856
Country	:	US
Telephone Number	:	407-579-3142
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 E OAK RIDGE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-4204
Country	:	US
Telephone Number	:	407-855-7199
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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