Healthcare Provider Details

I. General information

NPI: 1255581500
Provider Name (Legal Business Name): ABLE ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 MADISON ST 202
HOLLYWOOD FL
33020-6974
US

IV. Provider business mailing address

2015 MADISON ST 202
HOLLYWOOD FL
33020-6974
US

V. Phone/Fax

Practice location:
  • Phone: 954-394-4038
  • Fax: 954-239-5433
Mailing address:
  • Phone: 954-394-4038
  • Fax: 954-239-5433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP2457
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberAP2457
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberAP2457
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License NumberAP2457
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License NumberAP2457
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License NumberAP2457
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberAP2457
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberAP2457
License Number StateFL
# 9
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License NumberAP2457
License Number StateFL
# 10
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberAP2457
License Number StateFL
# 11
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License NumberAP2457
License Number StateFL
# 12
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License NumberAP2457
License Number StateFL
# 13
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License NumberAP2457
License Number StateFL
# 14
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberAP2457
License Number StateFL
# 15
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License NumberAP2457
License Number StateFL

VIII. Authorized Official

Name: MICHELE BOURGOUIN
Title or Position: OWNER
Credential: A.P., D.O.M.
Phone: 954-394-4038