Provider Demographics
NPI:1346574951
Name:MOJICA, ANJANETTE (DOM, LAC)
Entity Type:Individual
Prefix:DR
First Name:ANJANETTE
Middle Name:
Last Name:MOJICA
Suffix:
Gender:F
Credentials:DOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5437 LAKE MARGARET DRIVE
Mailing Address - Street 2:STE C
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812
Mailing Address - Country:US
Mailing Address - Phone:407-610-4156
Mailing Address - Fax:866-466-6953
Practice Address - Street 1:7450 DR PHILLIPS BLVD
Practice Address - Street 2:STE 301
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819
Practice Address - Country:US
Practice Address - Phone:407-610-4156
Practice Address - Fax:866-466-6953
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2352171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist