Healthcare Provider Details

I. General information

NPI: 1194180885
Provider Name (Legal Business Name): UNIFIED WELLNESS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2015
Last Update Date: 12/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 PONCE DE LEON ST
ROYAL PALM BEACH FL
33411-1213
US

IV. Provider business mailing address

106 PONCE DE LEON ST
ROYAL PALM BEACH FL
33411-1213
US

V. Phone/Fax

Practice location:
  • Phone: 954-801-3888
  • Fax: 561-791-9071
Mailing address:
  • Phone: 954-801-3888
  • Fax: 561-791-9071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: ANDREW J AGOADO
Title or Position: PRESIDENT
Credential: A.P.
Phone: 954-801-3888