Healthcare Provider Details
I. General information
NPI: 1699958546
Provider Name (Legal Business Name): HOLISTIC HEALTH AND MATERNITY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/14/2007
Last Update Date: 12/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7800 SW 57TH AVE SUITE216
SOUTH MIAMI FL
33143-5528
US
IV. Provider business mailing address
7800 SW 57TH AVE SUITE216
SOUTH MIAMI FL
33143-5528
US
V. Phone/Fax
- Phone: 305-663-5555
- Fax: 305-663-5555
- Phone: 305-663-5555
- Fax: 305-663-5555
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 136A00000X |
| Taxonomy | Registered Dietetic Technician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AP2164 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171R00000X |
| Taxonomy | Interpreter |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 175L00000X |
| Taxonomy | Homeopath |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 175M00000X |
| Taxonomy | Lay Midwife |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 176B00000X |
| Taxonomy | Midwife |
| License Number | MW176 |
| License Number State | FL |
| # 8 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AP1653 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
ANA
L
YOUNG
Title or Position: CLINIC DIRECTOR
Credential: AP
Phone: 305-663-5555