Healthcare Provider Details

I. General information

NPI: 1164081436
Provider Name (Legal Business Name): VERONICA CID L. AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2019
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8861 SW 142ND AVE APT 9-35
MIAMI FL
33186-4025
US

IV. Provider business mailing address

8861 SW 142ND AVE APT 9-35
MIAMI FL
33186-4025
US

V. Phone/Fax

Practice location:
  • Phone: 787-901-4928
  • Fax:
Mailing address:
  • Phone: 787-901-4928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number4057
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: