Healthcare Provider Details
I. General information
NPI: 1871819821
Provider Name (Legal Business Name): ACUPUNCTURE AND HERB SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/15/2010
Last Update Date: 04/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 N HIATUS RD STE 105
PEMBROKE PINES FL
33026-5213
US
IV. Provider business mailing address
10737 S PRESERVE WAY 208
MIRAMAR FL
33025-6557
US
V. Phone/Fax
- Phone: 561-843-1644
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | AP2754 |
| License Number State | FL |
VIII. Authorized Official
Name: MRS.
MONA
KHALIL
Title or Position: ACUPUNCTURE PHYSICIAN/ OWNER
Credential: AP
Phone: 561-843-1644