Healthcare Provider Details

I. General information

NPI: 1679825418
Provider Name (Legal Business Name): ACUPUNCTURE AAA & I, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2012
Last Update Date: 10/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

784 US 1 #3
NORTH PALM BEACH FL
33408-4415
US

IV. Provider business mailing address

784 US 1 #3
NORTH PALM BEACH FL
33408-4415
US

V. Phone/Fax

Practice location:
  • Phone: 941-284-5612
  • Fax: 561-625-3040
Mailing address:
  • Phone: 941-284-5612
  • Fax: 561-625-3040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number#3096
License Number StateFL

VIII. Authorized Official

Name: DR. DELORECE LARIE GIRARD
Title or Position: DOCTOR OF ORIENTAL MEDICINE
Credential: DOM, AP
Phone: 941-284-5612