MEDICARE: MR. JEFFREY ALAN PROL 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	AP 2434	FL

General Provider Information

NPI Number	:	1457550097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY ALAN PROL L AC.

Provider Business Mailing Address
First Line	:	975 W 41ST ST
Second Line	:	SUITE: 500
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3329
Country	:	US
Telephone Number	:	305-532-0777
Fax Number	:	305-532-0888

Provider Business Practice Location Address
First Line	:	975 W 41ST ST
Second Line	:	SUITE: 500
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3329
Country	:	US
Telephone Number	:	305-532-0777
Fax Number	:	305-532-0888

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

Provider Enumeration Date	:	07/13/2007
Last Update Date	:	07/13/2007

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