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General NPI Number Information
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NPI Number | 1144614462
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL CONSULTANT ASSCOATES INC
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Dates
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Enumeration Date | 03/25/2015
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 12651 W SUNRISE BLVD SUITE 102
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City | SUNRISE
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State | FL
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Zip | 33323-0906
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Country | US
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Telephone | 954-888-8355
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Fax |
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Provider Business Mailing Address
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Address Line | 12651 W SUNRISE BLVD STE 102
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City | SUNRISE
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State | FL
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Zip | 33323-0906
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Country | US
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Telephone | 954-888-8355
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LUIS VECCHI
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Credential |
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Telephone | 713-392-5818
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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 | AP3484
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License Number State | FL
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