MEDICARE: DAYTONA ACUPUNCUTRE AND PAIN MANAGEMENT CENTER LLC

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

General Provider Information

NPI Number	:	1770432932
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAYTONA ACUPUNCUTRE AND PAIN MANAGEMENT CENTER LLC

Provider Business Mailing Address
First Line	:	2135 S RIDGEWOOD AVE
Second Line	:
City	:	SOUTH DAYTONA
State	:	FL
Zip	:	32119-3015
Country	:	US
Telephone Number	:	386-760-2112
Fax Number	:

Provider Business Practice Location Address
First Line	:	2135 S RIDGEWOOD AVE
Second Line	:
City	:	SOUTH DAYTONA
State	:	FL
Zip	:	32119-3015
Country	:	US
Telephone Number	:	386-760-2112
Fax Number	:

Authorized Official
Title or Position	:	ACUPUNCTURIST
Name	:	DR. FENG ZOU LEE
Credential	:	DAOM
Telephone Number	:	252-578-1850

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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