Provider Demographics
NPI:1679727663
Name:TOMITA, JUDY KAZUKO (AP)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:KAZUKO
Last Name:TOMITA
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8603 S DIXIE HWY
Mailing Address - Street 2:SUITE #306
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7807
Mailing Address - Country:US
Mailing Address - Phone:305-663-8128
Mailing Address - Fax:
Practice Address - Street 1:8603 S DIXIE HWY
Practice Address - Street 2:SUITE #306
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-7807
Practice Address - Country:US
Practice Address - Phone:305-663-8128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2409171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist