Alma Vanessa Goldstein, L.AC., A.P.

Individual provider Active NPI Acupuncturist · Port St Lucie, FL

NPI 1013067024 · NPPES record last updated Nov 2, 2023

Key facts

NPI
1013067024
Entity type
Individual (NPI type 1)
Primary specialty
Acupuncturist 171100000X
License
AP2064 (FL)
Practice address
1430 SW Saint Lucie West Blvd Ste 103
Port St Lucie, FL 34986-2134
Phone
(772) 398-5400
Fax
(772) 446-4651
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2064FLMDAcupuncturist
AP2064FLMDAcupuncturist
00787NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Acupuncture of Tradition LLC Acupuncturist Current Accepting new patients

Locations

10050 SW Innovation Way
Ste 201
Port St Lucie, FL 34987
Phone (772) 781-2735

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 2064 FL
Acupuncturist 171100000X 00787 NY
Acupuncturist
Group: 193400000X SINGLE SPECIALTY GROUP
171100000X AP2064 FL Yes

Addresses

Primary practice location

1430 SW Saint Lucie West Blvd Ste 103
Port St Lucie, FL 34986-2134

Mailing address

1430 SW Saint Lucie West Blvd Ste 103
Port St Lucie, FL 34986-2134
Phone (772) 398-5400

Other identifiers

IdentifierTypeStateIssuer
00787OtherNYACUPUNCTURE LICENSE
AP2064OtherFLACUPUNCTURE LICENSE

Other providers in Port St Lucie, FL

All providers in Port St Lucie, FL · Acupuncturist in Florida

Sources for this page

Verify at the official NPI Registry.