Healthcare Provider Details

I. General information

NPI: 1508403148
Provider Name (Legal Business Name): XIN QIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2019
Last Update Date: 12/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12357 W DIXIE HWY
NORTH MIAMI FL
33161-5428
US

IV. Provider business mailing address

12357 W DIXIE HWY
NORTH MIAMI FL
33161-5428
US

V. Phone/Fax

Practice location:
  • Phone: 305-891-2888
  • Fax: 954-626-0396
Mailing address:
  • Phone: 305-891-2888
  • Fax: 954-626-0396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP4102
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: