Healthcare Provider Details

I. General information

NPI: 1104418797
Provider Name (Legal Business Name): COMPASSION ACUPUNCTURE & HOLISTIC HEALING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2021
Last Update Date: 12/23/2022
Certification Date: 12/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2818 E OAKLAND PARK BLVD
FORT LAUDERDALE FL
33306-1814
US

IV. Provider business mailing address

2625 SE 7TH ST
POMPANO BEACH FL
33062-6121
US

V. Phone/Fax

Practice location:
  • Phone: 954-594-0843
  • Fax:
Mailing address:
  • Phone: 954-594-0843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANDREA SMOUS
Title or Position: PRESIDENT
Credential: AP, ADS
Phone: 954-594-0843