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General NPI Number Information
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NPI Number | 1396980827
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Entity Type | Organization
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Legal Business Name | GARDENS WELLNESS TAMPA
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Dates
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Enumeration Date | 12/12/2008
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Last Update Date | 12/12/2008
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Provider Practice Location Address
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Address Line | 120 S HOWARD AVE
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City | TAMPA
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State | FL
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Zip | 33606-1725
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Country | US
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Telephone | 813-528-0870
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Fax |
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Provider Business Mailing Address
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Address Line | 2613 CHELSEA MANOR BLVD
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City | BRANDON
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State | FL
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Zip | 33510-4701
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | RAPHAEL TAMARI
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Credential |
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Telephone | 561-574-3615
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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 | AP2153
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License Number State | FL
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