MEDICARE: DR. IVY VU 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	AP3483	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730570318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IVY VU AP

Provider Business Mailing Address
First Line	:	1517 HILLCREST ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-4710
Country	:	US
Telephone Number	:	407-325-4577
Fax Number	:	888-487-1880

Provider Business Practice Location Address
First Line	:	1517 HILLCREST ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-4710
Country	:	US
Telephone Number	:	407-325-4577
Fax Number	:	888-487-1880

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

Provider Enumeration Date	:	02/18/2015
Last Update Date	:	03/17/2017

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