Provider Demographics
NPI:1912557521
Name:ACUPUNCTURE AND ORIENTAL MEDICINE CLINIC
Entity Type:Organization
Organization Name:ACUPUNCTURE AND ORIENTAL MEDICINE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WEI
Authorized Official - Middle Name:TONG
Authorized Official - Last Name:ZHAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-927-1071
Mailing Address - Street 1:5368 LONESOME DOVE DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-4624
Mailing Address - Country:US
Mailing Address - Phone:407-927-1071
Mailing Address - Fax:
Practice Address - Street 1:7932 W SAND LAKE RD STE 200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7299
Practice Address - Country:US
Practice Address - Phone:407-927-1071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center