Organization
EAST LAKE ACUPUNCTURE, LLC
Active
Other names
East Lake Acupuncture & Wellness, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEANNETTE R KERNS AP, DOM, L.AC. (PRESIDENT)
(407) 738-7412
Entity
Organization
Contact information
Practice address
819 E OAK ST STE B, KISSIMMEE, FL 34744-5842
(407) 738-7412
(321) 250-7841
Mailing address
PO BOX 700215, SAINT CLOUD, FL 34770-0215
(407) 738-7412
(321) 250-7841
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP 3178
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102479200
—
FL
01
—
12500125
CAQH
FL
Enumeration date
10/10/2012
Last updated
08/29/2025
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