Healthcare Provider Details

I. General information

NPI: 1346415791
Provider Name (Legal Business Name): ANTOINETTE NURCAN KOZANLI A.P., M.S. L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 SE 9TH ST
DEERFIELD BEACH FL
33441-5633
US

IV. Provider business mailing address

928 SE 14TH TER
DEERFIELD BEACH FL
33441-5855
US

V. Phone/Fax

Practice location:
  • Phone: 954-803-5081
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP 2295
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: