Healthcare Provider Details

I. General information

NPI: 1104090612
Provider Name (Legal Business Name): ELI CHAIMOWICZ L.AC.,L.M.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 04/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 N FEDERAL HWY SUITE 3
BOCA RATON FL
33487-3146
US

IV. Provider business mailing address

6501 N FEDERAL HWY SUITE 3
BOCA RATON FL
33487-3146
US

V. Phone/Fax

Practice location:
  • Phone: 561-353-4150
  • Fax: 561-353-4151
Mailing address:
  • Phone: 561-353-4150
  • Fax: 561-353-4151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA19004
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP1345
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: