Organization · NPI-2
100 Physicians Medicine, LLC
Acupuncturist · Lady Lake, FL
NPI number1407508930
StatusActive
Last updated in NPPESJan 26, 2022
Details
- NPI
- 1407508930
- Entity type
- Organization (NPI-2)
- Legal business name
- 100 Physicians Medicine, LLC
- Organization subpart
- No
- Enumeration date
- Jan 26, 2022
- Certification date
- Jan 26, 2022
- Last updated
- Jan 26, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171100000X | Acupuncturist | – | – | Yes |
Practice location
13721 N Us Highway 441 Ste 2Lady Lake, FL 32159-8910
Phone 352-254-5544
Mailing address
17495 Se 74th Raes Hall AveThe Villages, FL 32162-5352
Phone 505-900-1476
Authorized official
Miguel J De Puigdorfila
Managing Director
5059001476
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