Provider Demographics
NPI:1932472628
Name:AMERICAN ACADEMY OF TRADITIONAL CHINESE MEDICINE & ACUPUNCTURE
Entity Type:Organization
Organization Name:AMERICAN ACADEMY OF TRADITIONAL CHINESE MEDICINE & ACUPUNCTURE
Other - Org Name:ALL IN ONE ACUPUNCTURE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FENG
Authorized Official - Middle Name:
Authorized Official - Last Name:SONG
Authorized Official - Suffix:
Authorized Official - Credentials:AP OMD
Authorized Official - Phone:407-678-4520
Mailing Address - Street 1:6906 ALOMA AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-7003
Mailing Address - Country:US
Mailing Address - Phone:407-678-4520
Mailing Address - Fax:407-678-4520
Practice Address - Street 1:6906 ALOMA AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-7003
Practice Address - Country:US
Practice Address - Phone:407-678-4520
Practice Address - Fax:407-678-4520
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN ACADEMY OF TRADITIONAL CHINESE MEDICINE & ACUPUNCTURE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-11
Last Update Date:2012-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 478302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization