Healthcare Provider Details

I. General information

NPI: 1760856025
Provider Name (Legal Business Name): MOBILE ACUPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2015
Last Update Date: 11/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N UNIVERSITY DR STE 209
CORAL SPRINGS FL
33071-7394
US

IV. Provider business mailing address

6425 NW 77TH PL
PARKLAND FL
33067-2430
US

V. Phone/Fax

Practice location:
  • Phone: 954-721-5543
  • Fax:
Mailing address:
  • Phone: 786-853-0956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP2769
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA49734
License Number StateFL

VIII. Authorized Official

Name: DR. REYNA HOWELL
Title or Position: OWNER
Credential: DOM
Phone: 786-853-0956