Provider Demographics
NPI:1295031185
Name:ORIENTAL MEDICAL ARTS
Entity Type:Organization
Organization Name:ORIENTAL MEDICAL ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BRADNAN
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:407-325-2347
Mailing Address - Street 1:1330 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789
Mailing Address - Country:US
Mailing Address - Phone:407-325-2347
Mailing Address - Fax:
Practice Address - Street 1:1802 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1854
Practice Address - Country:US
Practice Address - Phone:407-392-1441
Practice Address - Fax:407-392-1443
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CENTER OF WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-10
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2091171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty