MEDICARE: MRS. TONI M. KREHEL 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	AP812	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C004S	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1396845566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TONI M. KREHEL AP

Provider Business Mailing Address
First Line	:	6000A SAWGRASS VILLAGE CIR
Second Line	:
City	:	PONTE VEDRA
State	:	FL
Zip	:	32082-5011
Country	:	US
Telephone Number	:	904-280-0990
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000A SAWGRASS VILLAGE CIR
Second Line	:
City	:	PONTE VEDRA
State	:	FL
Zip	:	32082-5011
Country	:	US
Telephone Number	:	904-280-0990
Fax Number	:

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	07/08/2007

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