MEDICARE: A CENTER FOR ALTERNATIVE MEDICINE AND SPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center	MM13444	FL

General Provider Information

NPI Number	:	1881839074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A CENTER FOR ALTERNATIVE MEDICINE AND SPA

Provider Business Mailing Address
First Line	:	40 FAIRWAY DR
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-1854
Country	:	US
Telephone Number	:	954-428-6999
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 FAIRWAY DR
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-1854
Country	:	US
Telephone Number	:	954-428-6999
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LINDA ELLEN LEGUNN
Credential	:
Telephone Number	:	954-428-6999

Provider Enumeration Date	:	12/03/2008
Last Update Date	:	12/03/2008

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