MEDICARE: JACQUELINE O'MEARA AP

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 2670	FL

General Provider Information

NPI Number	:	1700101094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE O'MEARA AP

Provider Business Mailing Address
First Line	:	124 LAKESHORE DR
Second Line	:	PH31
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3607
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	:	561-628-8701
Fax Number	:

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

Provider Enumeration Date	:	03/30/2010
Last Update Date	:	03/30/2010

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