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General NPI Number Information
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NPI Number | 1164664744
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Entity Type | Organization
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Legal Business Name | OPTIMAL BEING INC.
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Dates
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Enumeration Date | 03/30/2009
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Last Update Date | 03/30/2009
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Provider Practice Location Address
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Address Line | 499 E. CENTRAL PKWY. STE. 215
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701
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Country | US
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Telephone | 407-701-7841
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Fax | 407-332-1206
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Provider Business Mailing Address
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Address Line | 143 EASTERN FORK
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City | LONGWOOD
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State | FL
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Zip | 32750
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Country | US
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Telephone | 407-701-7841
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Fax | 407-332-1206
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Authorized Official
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Title or Position | ACUPUNCTURE PHYSICIAN
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Name | MONIQUE ROGERS
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Credential | A.P., D.O.M.
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Telephone | 407-701-7841
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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 | AP1781
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License Number State | FL
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