MEDICARE: ACUPUNCTURE & HERBAL THERAPIES

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	225700000X	Massage Therapist	MM29770	FL
2	171100000X	Acupuncturist	AP1965	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CO946	OTHER	FL	BCBS NUMBER

General Provider Information

NPI Number	:	1942359070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACUPUNCTURE & HERBAL THERAPIES

Provider Business Mailing Address
First Line	:	2520 CENTRAL AVE.
Second Line	:
City	:	ST. PETERSBURG
State	:	FL
Zip	:	33712
Country	:	US
Telephone Number	:	727-551-0857
Fax Number	:	727-202-6896

Provider Business Practice Location Address
First Line	:	2520 CENTRAL AVE.
Second Line	:
City	:	ST. PETERSBURG
State	:	FL
Zip	:	33712
Country	:	US
Telephone Number	:	727-551-0857
Fax Number	:	727-202-6896

Authorized Official
Title or Position	:	ACUPUNCTURE PHYSICIAN
Name	:	ROBERT LINDE
Credential	:	A.P.
Telephone Number	:	727-551-0857

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/19/2018

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Directions to “ACUPUNCTURE & HERBAL THERAPIES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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