Provider Demographics
NPI:1770830747
Name:ORLANDO ACUPUNCTURE AND WELLNESS, LLC
Entity Type:Organization
Organization Name:ORLANDO ACUPUNCTURE AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:954-993-0994
Mailing Address - Street 1:1922 BONANZA CT
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2026
Mailing Address - Country:US
Mailing Address - Phone:954-993-0994
Mailing Address - Fax:
Practice Address - Street 1:300 WILSHIRE BLVD
Practice Address - Street 2:SUITE 237
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5378
Practice Address - Country:US
Practice Address - Phone:954-993-0994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2300171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty