Healthcare Provider Details

I. General information

NPI: 1437534567
Provider Name (Legal Business Name): CENTER FOR ADVANCED ACUPUNCTURE & INTEGRATIVE MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5739 GALL BLVD
ZEPHYRHILLS FL
33542-3453
US

IV. Provider business mailing address

5739 GALL BLVD
ZEPHYRHILLS FL
33542-3453
US

V. Phone/Fax

Practice location:
  • Phone: 813-588-2028
  • Fax: 813-317-7713
Mailing address:
  • Phone: 813-588-2028
  • Fax: 813-317-7713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberL13000035136
License Number StateFL

VIII. Authorized Official

Name: MATTHEW DEBONA
Title or Position: LAC, DOM
Credential: LAC, DOM
Phone: 813-588-2028