Healthcare Provider Details

I. General information

NPI: 1457579997
Provider Name (Legal Business Name): A SUPER HEALTH CARE CENTER,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15300 JOG RD SUITE 209
DELRAY BEACH FL
33446-2162
US

IV. Provider business mailing address

15300 JOG RD SUITE 209
DELRAY BEACH FL
33446-2162
US

V. Phone/Fax

Practice location:
  • Phone: 561-381-3303
  • Fax: 954-753-6681
Mailing address:
  • Phone: 561-381-3303
  • Fax: 954-753-6681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP0000968
License Number StateFL

VIII. Authorized Official

Name: DR. HAN MING DU
Title or Position: PRESIDENT
Credential: AP
Phone: 561-381-3303