Healthcare Provider Details

I. General information

NPI: 1548400062
Provider Name (Legal Business Name): GUQQI ACUPUNCTURE & WELLNESS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2009
Last Update Date: 02/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 SEVEN SPRINGS BLVD SUITE 112
TRINITY FL
34655-3911
US

IV. Provider business mailing address

2200 SEVEN SPRINGS BLVD SUITE 112
TRINITY FL
34655-3911
US

V. Phone/Fax

Practice location:
  • Phone: 727-376-8777
  • Fax:
Mailing address:
  • Phone: 727-376-8777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP 2538
License Number StateFL

VIII. Authorized Official

Name: LISA MERRITT
Title or Position: PRESIDENT
Credential: AP
Phone: 813-659-2502