MEDICARE: DRAGON RISES SCHOOL OF ORIENTAL MEDICINE

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	261Q00000X	Clinic/Center	2425	FL

General Provider Information

NPI Number	:	1932358207
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRAGON RISES SCHOOL OF ORIENTAL MEDICINE

Provider Business Mailing Address
First Line	:	1000 NE 16TH AVE
Second Line	:	BLDG. F
City	:	GAINESVILLE
State	:	FL
Zip	:	32601-4557
Country	:	US
Telephone Number	:	352-371-2833
Fax Number	:	352-371-2867

Provider Business Practice Location Address
First Line	:	1000 NE 16TH AVE
Second Line	:	BLDG. F
City	:	GAINESVILLE
State	:	FL
Zip	:	32601-4557
Country	:	US
Telephone Number	:	352-371-2833
Fax Number	:	352-371-2867

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. CYNTHIA E GRAY
Credential	:	RN,AP,DIPL. AC.,
Telephone Number	:	352-371-2833

Provider Enumeration Date	:	09/11/2008
Last Update Date	:	09/11/2008

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Directions to “DRAGON RISES SCHOOL OF ORIENTAL MEDICINE ” Practice Location

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