Healthcare Provider Details
I. General information
NPI: 1457622565
Provider Name (Legal Business Name): FALCON HEALING INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/20/2012
Last Update Date: 11/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7800 RED ROAD SUITE 108
MIAMI FL
33143-7927
US
IV. Provider business mailing address
8316 SW 65TH AVE APT 3
MIAMI FL
33143-7927
US
V. Phone/Fax
- Phone: 305-721-7682
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AP 3336 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | MA 57057 |
| License Number State | FL |
VIII. Authorized Official
Name:
GRETEL
GARCIA
Title or Position: PRESIDENT
Credential: A.P, LMT
Phone: 305-721-7682