Provider Demographics
NPI:1073127106
Name:BRUDZINSKI, LINDSAY (AP, MOAM, DIPOM)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:BRUDZINSKI
Suffix:
Gender:F
Credentials:AP, MOAM, DIPOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 358664
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32635-8664
Mailing Address - Country:US
Mailing Address - Phone:727-688-1590
Mailing Address - Fax:
Practice Address - Street 1:920 NW 8TH AVE # A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-5071
Practice Address - Country:US
Practice Address - Phone:727-688-1590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-05
Last Update Date:2020-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP4172171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist