Jesse Stayton Brock, A.P. DOM
Individual provider Active NPI Acupuncturist · Parrish, FL
NPI 1659141968 · NPPES record last updated Jan 8, 2024
Key facts
- NPI
- 1659141968
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acupuncturist 171100000X
- License
- AP4543 (FL)
- Practice address
- 11270 82ND St E
Parrish, FL 34219-2705 - Phone
- (941) 504-2372
- NPI assigned
- Jan 8, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP4543 | FL | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brock Integrative Health Inc | Acupuncturist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AP4543 | FL | Yes |
Addresses
Primary practice location
11270 82ND St E
Parrish, FL 34219-2705
Mailing address
11270 82ND St E
Parrish, FL 34219-2705
Phone (941) 504-2372
Other providers in Parrish, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.