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Contact Information

EAST LAKE ACUPUNCTURE, LLC
819 E OAK ST STE B
KISSIMMEE, FL34744-5842
 Phone: 407-738-7412
 Fax: 321-250-7841
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acupuncturist

171100000X
Indicates primary specialty

NPI Profile & details for EAST LAKE ACUPUNCTURE LLC · (Female)

NPI # 1356693709
Status Active
Credentials
Entity Individual
Enumeration date 10/10/2012
Last updated 08/29/2025 - About 9 months ago
Sole proprietor 1 Not specified
Identifiers
  • FL License # AP 3178
  • FL Medicaid 102479200
  • FL Other 12500125 CAQH
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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