Healthcare Provider Details

I. General information

NPI: 1235530148
Provider Name (Legal Business Name): URBAN ACUPUNCTURE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2014
Last Update Date: 09/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13501 SW 136TH ST
MIAMI FL
33186-8319
US

IV. Provider business mailing address

8240 SW 98TH ST
MIAMI FL
33156-2556
US

V. Phone/Fax

Practice location:
  • Phone: 305-256-1162
  • Fax:
Mailing address:
  • Phone: 786-333-6695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP3537
License Number StateFL

VIII. Authorized Official

Name: DR. STEPHANIE URBAN
Title or Position: OWNER
Credential:
Phone: 786-333-6695