Healthcare Provider Details

I. General information

NPI: 1760023840
Provider Name (Legal Business Name): KHEIRON ACU-THERAPEUTAE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2019
Last Update Date: 09/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6520 WINFIELD BLVD APT 104
MARGATE FL
33063-7135
US

IV. Provider business mailing address

6520 WINFIELD BLVD APT 104
MARGATE FL
33063-7135
US

V. Phone/Fax

Practice location:
  • Phone: 954-815-9461
  • Fax:
Mailing address:
  • Phone: 954-815-9461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JUAN MORALES
Title or Position: ACUPUNCTURIST
Credential: L.AC
Phone: 954-815-9461