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General NPI Number Information
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NPI Number | 1306117320
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Entity Type | Organization
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Legal Business Name | MIAMI SHORES HOLISTIC HEALTH, INC.
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 9999 NE 2ND AVE STE 300
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2346
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Country | US
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Telephone | 305-999-5527
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Fax |
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Provider Business Mailing Address
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Address Line | 9999 NE 2ND AVE STE 300
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2346
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Country | US
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Telephone | 305-999-5527
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURE PHYSICIAN
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Name | KIMBERLY A. KRAUSE
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Credential |
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Telephone | 305-999-5527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AP2999
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License Number State | FL
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