Healthcare Provider Details

I. General information

NPI: 1346144854
Provider Name (Legal Business Name): FERNANDA GROSSI L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 NE 65TH ST APT 633
FORT LAUDERDALE FL
33308-1573
US

IV. Provider business mailing address

2400 NE 65TH ST APT 633
FORT LAUDERDALE FL
33308-1573
US

V. Phone/Fax

Practice location:
  • Phone: 954-681-3719
  • Fax:
Mailing address:
  • Phone: 954-681-3719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU03329
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: