Provider Demographics
NPI:1255517140
Name:REYNOLDS, PAUL CHRISTOPHER (AP)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:CHRISTOPHER
Last Name:REYNOLDS
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1298 MINNESOTA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-7104
Mailing Address - Country:US
Mailing Address - Phone:727-487-3328
Mailing Address - Fax:407-539-1996
Practice Address - Street 1:1404 STRATFORD RD
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-3529
Practice Address - Country:US
Practice Address - Phone:727-487-3328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1589171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist