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NPI Code Detail

MEDICARE: MRS. DAWN LAVELLE SHARE A.P.

MEDICARE: MRS. DAWN LAVELLE SHARE A.P.
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
1171100000XAcupuncturistAP2726FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
127-5007598OTHERFLIRS
227-0959639OTHERFLIRS

General Provider Information

NPI Number : 1477887784
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DAWN LAVELLE SHARE A.P.
Provider Business Mailing Address
First Line : 145 HERITAGE CIR
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-4208
Country : US
Telephone Number : 386-290-9493
Fax Number :
Provider Business Practice Location Address
First Line : 1400 HAND AVE STE N
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-8196
Country : US
Telephone Number : 386-290-9493
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2009
Last Update Date : 09/10/2012

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