MEDICARE: MRS. PAULA P MOSS 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
1	171100000X	Acupuncturist	AP3187	FL

General Provider Information

NPI Number	:	1588918171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAULA P MOSS A.P.

Provider Business Mailing Address
First Line	:	5055 DALEWOOD LN
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-1844
Country	:	US
Telephone Number	:	561-703-8030
Fax Number	:

Provider Business Practice Location Address
First Line	:	5055 DALEWOOD LN
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-1844
Country	:	US
Telephone Number	:	561-703-8030
Fax Number	:

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

Provider Enumeration Date	:	11/03/2012
Last Update Date	:	04/08/2014

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