MEDICARE: DR. PRANA GOGIA DAOM. LAP.

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	16634	CA
2	171100000X	Acupuncturist	4148	FL

General Provider Information

NPI Number	:	1831570084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRANA GOGIA DAOM. LAP.

Provider Business Mailing Address
First Line	:	300 DIPLOMAT PKWY APT 204
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-3707
Country	:	US
Telephone Number	:	786-584-7726
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 71ST ST STE 302
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-3234
Country	:	US
Telephone Number	:	786-584-7726
Fax Number	:

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

Provider Enumeration Date	:	06/13/2015
Last Update Date	:	04/19/2022

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