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General NPI Number Information
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NPI Number | 1144707068
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Entity Type | Organization
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Legal Business Name | ALTERNATIVE MEDICINE ACUPUNCTURE
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 09/12/2020
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Provider Practice Location Address
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Address Line | 2605 W SWANN AVE STE 600
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City | TAMPA
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State | FL
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Zip | 33609
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Country | US
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Telephone | 813-444-2020
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Fax | 813-877-1277
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Provider Business Mailing Address
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Address Line | PO BOX 152592
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City | TAMPA
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State | FL
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Zip | 33684-2592
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Country | US
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Telephone | 813-444-2020
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. IVAYLO GUEORGUIEV
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Credential | DOM, AP
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Telephone | 813-444-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | AP3960
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP3960
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License Number State | FL
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