Provider Demographics
NPI:1780003939
Name:FITZSIMMONS, APRIL (LAC)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:FITZSIMMONS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 BIG MAGNOLIA CT
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-4750
Mailing Address - Country:US
Mailing Address - Phone:808-430-7900
Mailing Address - Fax:
Practice Address - Street 1:69 S DIXIE HWY
Practice Address - Street 2:C1
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-4186
Practice Address - Country:US
Practice Address - Phone:808-430-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3401171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist