MEDICARE: HIROKO SHIMODA D.O.M., L.AC.

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	AP2573	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336394493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIROKO SHIMODA D.O.M., L.AC.

Provider Business Mailing Address
First Line	:	650 MAITLAND AVE
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-6862
Country	:	US
Telephone Number	:	407-497-8446
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 MAITLAND AVE
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-6862
Country	:	US
Telephone Number	:	407-497-8446
Fax Number	:

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

Provider Enumeration Date	:	11/17/2008
Last Update Date	:	04/17/2018

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