Healthcare Provider Details

I. General information

NPI: 1942560701
Provider Name (Legal Business Name): MERIDITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2012
Last Update Date: 05/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9180 FOREST HILL BLVD
WELLINGTON FL
33411
US

IV. Provider business mailing address

7695 FORESTAY DRIVE
LAKE WORTH FL
33467
US

V. Phone/Fax

Practice location:
  • Phone: 561-333-5351
  • Fax:
Mailing address:
  • Phone: 561-439-6840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number2986
License Number StateFL

VIII. Authorized Official

Name: MS. MEREDITH ANNE VORRATH
Title or Position: ACUPUNCTURE PHYSICIAN
Credential: AP
Phone: 561-523-9774