Healthcare Provider Details

I. General information

NPI: 1295020030
Provider Name (Legal Business Name): DEERFIELD BEACH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 SE 8TH AVE SUITE 209
DEERFIELD BEACH FL
33441-5644
US

IV. Provider business mailing address

811 SE 8TH AVE SUITE 209
DEERFIELD BEACH FL
33441-5644
US

V. Phone/Fax

Practice location:
  • Phone: 954-427-1663
  • Fax:
Mailing address:
  • Phone: 954-427-1663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: ANALI GARCIA
Title or Position: PRESIDENT
Credential: D.O.M., A.P.
Phone: 954-427-1663