Healthcare Provider Details

I. General information

NPI: 1144625377
Provider Name (Legal Business Name): YIN YANG BALANCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2014
Last Update Date: 10/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11623 SW 143RD AVE
MIAMI FL
33186-8609
US

IV. Provider business mailing address

11623 SW 143RD AVE
MIAMI FL
33186-8609
US

V. Phone/Fax

Practice location:
  • Phone: 786-346-4906
  • Fax:
Mailing address:
  • Phone: 786-346-4906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP3551
License Number StateFL

VIII. Authorized Official

Name: FRANSE E LOZADA
Title or Position: ACUPUNCTURE PHYSICIAN
Credential: A.P.,D.O.M.
Phone: 786-346-4906