Healthcare Provider Details
I. General information
NPI: 1679229751
Provider Name (Legal Business Name): MY HEALTH ACUPUNCTURE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2022
Last Update Date: 02/26/2022
Certification Date: 02/26/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1700 N DIXIE HWY STE 109
BOCA RATON FL
33432-1807
US
IV. Provider business mailing address
1700 N DIXIE HWY STE 109
BOCA RATON FL
33432-1807
US
V. Phone/Fax
- Phone: 954-470-8371
- Fax:
- Phone: 954-470-8371
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
FANGMING
XU
Title or Position: ADMINISTRATOR
Credential:
Phone: 954-470-8371