Provider Demographics
NPI:1174996441
Name:POSADA, ADRIANA (DOM, AP)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:POSADA
Suffix:
Gender:F
Credentials:DOM, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 A1A N
Mailing Address - Street 2:UNIT 6
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-2760
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:504 OSCEOLA AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-4030
Practice Address - Country:US
Practice Address - Phone:904-540-6568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-08
Last Update Date:2015-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3638171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist