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General NPI Number Information
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NPI Number | 1043766777
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Entity Type | Organization
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Legal Business Name | RONEL CORBIN WELLNESS MEDICINE INCE
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 9526 NE 2ND AVE SUITE 103
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City | MIAMI SHORES
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State | FL
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Zip | 33138
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Country | US
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Telephone | 305-306-6566
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Fax |
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Provider Business Mailing Address
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Address Line | 9526 NE 2ND AVE SUITE 103
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City | MIAMI SHORES
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State | FL
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Zip | 33138
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Country | US
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Telephone | 305-306-6566
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. RONEL CORBIN
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Credential | D.O.M
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Telephone | 305-562-7600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP3632
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License Number State | FL
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