Provider Demographics
NPI:1386077428
Name:ENGELHARD, GEORGE WILLIAM (LMT, AP)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:WILLIAM
Last Name:ENGELHARD
Suffix:
Gender:M
Credentials:LMT, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7345 W SAND LAKE RD
Mailing Address - Street 2:SUITE 221
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5284
Mailing Address - Country:US
Mailing Address - Phone:407-340-0822
Mailing Address - Fax:
Practice Address - Street 1:7345 W SAND LAKE RD
Practice Address - Street 2:SUITE 221
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5284
Practice Address - Country:US
Practice Address - Phone:407-340-0822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 3071171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist