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General NPI Number Information
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NPI Number | 1083919492
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Entity Type | Organization
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Legal Business Name | ANDERSON ACUPUNCTURE AND AESTHETICS CORP.
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Dates
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Enumeration Date | 01/14/2011
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Last Update Date | 01/14/2011
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Provider Practice Location Address
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Address Line | 23123 STATE ROAD 7 STE 236B
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City | BOCA RATON
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State | FL
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Zip | 33428-5489
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Country | US
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Telephone | 561-922-9391
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Fax |
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Provider Business Mailing Address
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Address Line | 23123 STATE ROAD 7 STE 236B
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City | BOCA RATON
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State | FL
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Zip | 33428-5489
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Country | US
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Telephone | 561-922-9391
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURE PHYSICIAN
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Name | ANDERSON CARLOS GONCALVES
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Credential | AP
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Telephone | 561-922-9391
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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 | AP2745
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License Number State | FL
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