MEDICARE: AMY WHITE

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	3542	FL

General Provider Information

NPI Number	:	1427455369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY WHITE

Provider Business Mailing Address
First Line	:	110 N ORLANDO AVE
Second Line	:	SUITE 3
City	:	MAITLAND
State	:	FL
Zip	:	32751-5574
Country	:	US
Telephone Number	:	407-234-6454
Fax Number	:	407-599-0750

Provider Business Practice Location Address
First Line	:	110 N ORLANDO AVE
Second Line	:	SUITE 3
City	:	MAITLAND
State	:	FL
Zip	:	32751-5574
Country	:	US
Telephone Number	:	407-234-6454
Fax Number	:	407-599-0750

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

Provider Enumeration Date	:	11/20/2014
Last Update Date	:	11/20/2014

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Directions to “ AMY WHITE ” Practice Location

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