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NPI Code Detail

MEDICARE: MRS. LINDA VONGKHAMPHRA A.P

MEDICARE: MRS. LINDA VONGKHAMPHRA 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
1171100000XAcupuncturistAP 2461FL

General Provider Information

NPI Number : 1891973012
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINDA VONGKHAMPHRA A.P
Provider Business Mailing Address
First Line : 1030 S STATE ROAD 7
Second Line :
City : PLANTATION
State : FL
Zip : 33317-4525
Country : US
Telephone Number : 954-581-3333
Fax Number :
Provider Business Practice Location Address
First Line : 1030 S STATE ROAD 7
Second Line :
City : PLANTATION
State : FL
Zip : 33317-4525
Country : US
Telephone Number : 954-581-3333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2008
Last Update Date : 02/11/2008

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Directions to “ MRS. LINDA VONGKHAMPHRA A.P” Practice Location

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