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General NPI Number Information
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NPI Number | 1104132059
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Entity Type | Individual
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Provider Name | IVONNE HERRAN A.P.
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Gender | Female
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Dates
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Enumeration Date | 08/28/2010
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Last Update Date | 08/28/2010
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Provider Practice Location Address
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Address Line | 23008 SANDALFOOT PLAZA DR
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City | BOCA RATON
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State | FL
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Zip | 33428-6654
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Country | US
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Telephone | 954-856-9349
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Fax |
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Provider Business Mailing Address
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Address Line | 5571 LAKESIDE DR APT 103
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City | MARGATE
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State | FL
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Zip | 33063-7659
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Country | US
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Telephone | 954-856-9349
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | AP2200
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License Number State | FL
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