Provider Demographics
NPI:1457550097
Name:PROL, JEFFREY ALAN (L AC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:ALAN
Last Name:PROL
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:975 W 41ST ST
Mailing Address - Street 2:SUITE: 500
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3329
Mailing Address - Country:US
Mailing Address - Phone:305-532-0777
Mailing Address - Fax:305-532-0888
Practice Address - Street 1:975 W 41ST ST
Practice Address - Street 2:SUITE: 500
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3329
Practice Address - Country:US
Practice Address - Phone:305-532-0777
Practice Address - Fax:305-532-0888
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2434171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist