Healthcare Provider Details
I. General information
NPI: 1538080965
Provider Name (Legal Business Name): 305 ACUMED & ORTHOSPORT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7213 NW 54TH ST
MIAMI FL
33166-4807
US
IV. Provider business mailing address
7213 NW 54TH ST
MIAMI FL
33166-4807
US
V. Phone/Fax
- Phone: 305-926-8441
- Fax:
- Phone: 305-926-8441
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DANIEL
L
LOPEZ
Title or Position: OWNER
Credential: DACCHM
Phone: 305-926-8441