Provider Demographics
NPI:1679000467
Name:ORLANDO HOLISTIC ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:ORLANDO HOLISTIC ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURE PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JIGNESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PANCHAL
Authorized Official - Suffix:
Authorized Official - Credentials:AP, DOM
Authorized Official - Phone:407-683-3995
Mailing Address - Street 1:2221 LEE RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1864
Mailing Address - Country:US
Mailing Address - Phone:407-683-3995
Mailing Address - Fax:
Practice Address - Street 1:2221 LEE RD
Practice Address - Street 2:SUITE 14
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1864
Practice Address - Country:US
Practice Address - Phone:407-683-3995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2946171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty