MEDICARE: OCEAN ACUPUNCTURE OF NORTH PALM BEACH

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	AP2670	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1700101094	OTHER	FL	1700101094

General Provider Information

NPI Number	:	1528369857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEAN ACUPUNCTURE OF NORTH PALM BEACH

Provider Business Mailing Address
First Line	:	1216 US HIGHWAY 1
Second Line	:	SUITE A
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3537
Country	:	US
Telephone Number	:	561-429-6155
Fax Number	:

Provider Business Practice Location Address
First Line	:	1216 US HIGHWAY 1
Second Line	:	SUITE A
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3537
Country	:	US
Telephone Number	:	561-429-6155
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JACQUELINE OMEARA
Credential	:	AP
Telephone Number	:	561-429-6155

Provider Enumeration Date	:	11/03/2010
Last Update Date	:	11/03/2010

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