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General NPI Number Information
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NPI Number | 1235894304
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Entity Type | Organization
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Legal Business Name | RIVERVIEW ACUPUNCTURE & WELLNESS CENTER LLC
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Dates
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Enumeration Date | 11/03/2021
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Last Update Date | 11/03/2021
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Provider Practice Location Address
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Address Line | 10015 PARK PLACE AVE # A
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City | RIVERVIEW
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State | FL
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Zip | 33578-5303
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Country | US
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Telephone | 813-399-6011
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Fax | 267-502-1689
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Provider Business Mailing Address
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Address Line | 13712 MOONSTONE CANYON DR # A
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City | RIVERVIEW
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State | FL
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Zip | 33579-3504
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Country | US
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Telephone | 813-399-6011
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Fax | 267-502-1689
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Authorized Official
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Title or Position | OWNER
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Name | MARIA FERNANDA CARVAJAL
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Credential | A.P.
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Telephone | 813-399-6011
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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 |
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License Number State |
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