Carolyn Cook, AP

Individual provider Active NPI Acupuncturist · Pinecrest, FL

NPI 1366708463 · NPPES record last updated Apr 3, 2012

Key facts

NPI
1366708463
Entity type
Individual (NPI type 1)
Primary specialty
Acupuncturist 171100000X
License
AP974 (FL)
Practice address
9655 S Dixie Hwy
Suite 204
Pinecrest, FL 33156-2813
Phone
(305) 665-9711
NPI assigned
Apr 3, 2012
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
AP974FLMDAcupuncturist
MA16840FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Classical Herbs and Acupuncture, Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AP974 FL Yes
Specialist 174400000X MA16840 FL

Addresses

Primary practice location

9655 S Dixie Hwy
Suite 204
Pinecrest, FL 33156-2813

Mailing address

9655 S Dixie Hwy
Suite 204
Pinecrest, FL 33156-2813
Phone (305) 665-9711

Other identifiers

IdentifierTypeStateIssuer
C0774OtherFLBCBS
C7258OtherFLBCBS

Other providers in Pinecrest, FL

All providers in Pinecrest, FL · Acupuncturist in Florida

Sources for this page

Verify at the official NPI Registry.