MEDICARE: TAMPA TOP ACUPUNCTURE & HERBS LLC

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	AP3615	FL

General Provider Information

NPI Number	:	1275904161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMPA TOP ACUPUNCTURE & HERBS LLC

Provider Business Mailing Address
First Line	:	1830 MONTGOMERY BELL RD
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-7188
Country	:	US
Telephone Number	:	813-334-9694
Fax Number	:

Provider Business Practice Location Address
First Line	:	2253 GREEN HEDGES WAY STE 101
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-6969
Country	:	US
Telephone Number	:	813-334-9694
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DONGCHEUL KANG
Credential	:
Telephone Number	:	813-334-9694

Provider Enumeration Date	:	10/18/2015
Last Update Date	:	04/13/2016

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