Provider Demographics
NPI:1114315686
Name:ACUMEDGROUP
Entity Type:Organization
Organization Name:ACUMEDGROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSNAK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LAC, AP, DOM
Authorized Official - Phone:407-624-5258
Mailing Address - Street 1:103 W OAK ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4401
Mailing Address - Country:US
Mailing Address - Phone:407-624-5258
Mailing Address - Fax:407-289-4047
Practice Address - Street 1:103 W OAK ST
Practice Address - Street 2:SUITE B
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4401
Practice Address - Country:US
Practice Address - Phone:407-624-5258
Practice Address - Fax:407-289-4047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 3582171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty