Healthcare Provider Details

I. General information

NPI: 1497356455
Provider Name (Legal Business Name): HOLISTIC CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2020
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 KANE CONCOURSE STE 205
BAY HARBOR ISLANDS FL
33154-2068
US

IV. Provider business mailing address

1108 KANE CONCOURSE STE 205
BAY HARBOR ISLANDS FL
33154-2068
US

V. Phone/Fax

Practice location:
  • Phone: 786-863-1114
  • Fax: 305-709-0563
Mailing address:
  • Phone: 786-863-1114
  • Fax: 305-709-0563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. EMILIA C CABRERA
Title or Position: DR
Credential: D.A.O.M
Phone: 786-863-1114